Department of Industrial Engineering, University of Florence, Florence, Italy.
Department of Pediatric Surgery, Meyer Children's Hospital, Florence, Italy.
Ann Thorac Surg. 2018 Jul;106(1):221-227. doi: 10.1016/j.athoracsur.2018.02.024. Epub 2018 Mar 13.
Current approaches to quantifying the severity of pectus excavatum require internal measurements based on cross-sectional imaging. The aim of this study is to exploit a novel index evaluated on the external surface of the chest with a three-dimensional (3D) optical scanner.
Fifty-one children (41 male, 10 female) between 2 and 17 years of age were evaluated with a 3D optical scanner. Pectus excavatum severity was calculated by using an ad hoc instant 3D scanner and defining an automatic procedure to generate an optical 3D correction index (CI3D). For the latter, an ideal threshold was derived from a statistical analysis, and five blind surveys were collected from pediatric specialists on chest wall deformities. The CI3D was then correlated with blind clinical assessments of PE severity.
The cutoff thresholds were determined to optimally discriminate between six degrees of severity of PE patients by a correlation analysis. The correlation coefficient obtained by matching the CI3D with the average subjective severity shows that the proposed method outperforms traditional approaches.
The optical 3D index has a good match with the average subjective assessment in distinguishing patients with mild to severe PE. This innovative approach offers several advantages over existing indices, as it is repeatable and does not require cross-sectional imaging. The index might be particularly suitable for monitoring the efficacy of nonoperative treatment and, in the future, for designing an optimal personalized usage of therapeutic devices.
目前评估漏斗胸严重程度的方法需要基于横断面成像的内部测量。本研究旨在利用三维（3D）光学扫描仪评估胸部外表面的一种新指数。
对 51 名 2 至 17 岁的儿童进行了 3D 光学扫描仪评估。使用特定的即时 3D 扫描仪计算漏斗胸严重程度，并定义了一种自动生成光学 3D 校正指数（CI3D）的程序。对于后者，从统计学分析中得出了一个理想的阈值，并由五名小儿胸壁畸形专科医生进行了五次盲法调查。然后将 CI3D 与 PE 严重程度的盲法临床评估进行了相关性分析。
通过相关分析确定了最佳的分类截断阈值，以区分 6 种严重程度的漏斗胸患者。通过将 CI3D 与平均主观严重程度进行匹配得到的相关系数表明，该方法优于传统方法。
光学 3D 指数在区分轻度至重度 PE 患者方面与平均主观评估具有良好的匹配度。与现有的指数相比，这种创新方法具有许多优势，因为它是可重复的，并且不需要进行横断面成像。该指数特别适合监测非手术治疗的疗效，并且在未来可以设计出治疗设备的最佳个性化使用。
