Szafer Dalia, Taylor Jordan S, Pei Allison, de Ruijter Vivian, Hosseini Hadi, Chao Stephanie, Wall James
1 Stanford University School of Medicine , Department of Surgery, Stanford, California.
2 Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children's Hospital at Stanford University , Stanford, California.
J Laparoendosc Adv Surg Tech A. 2019 Feb;29(2):267-271. doi: 10.1089/lap.2018.0191. Epub 2018 Sep 12.
Pectus excavatum and carinatum are two of the most commonly observed chest wall deformities in pediatrics. The standard diagnostic evaluation for these conditions includes either chest radiograph (CXR) or computed tomography (CT). Our research aims to develop a novel and reliable way of quantifying chest wall deformities in the clinic setting without radiation exposure.
Using a handheld structured light scanner, we created three-dimensional (3D) models of patients with chest wall deformities through an IRB-approved protocol. Raters from a variety of backgrounds were then asked to take measurements based on the 3D model utilizing commercially available 3D graphical software. The standard deviation of the measurements and intraclass correlation coefficient (ICC) were then calculated to quantify inter-rater reliability.
Sixty patients with pectus excavatum (Haller index range 2.0-6.38) and pectus carinatum were enrolled and imaged in our outpatient clinic using a structured light scanner. Five patients were used to verify interuser reliability. The standard deviation of all the measurements was 2.2 mm. The ICC for absolute agreement was 0.99139, with 1.0 being perfect correlation.
Structured light scanners provide an alternative approach to quantifying chest wall deformities in pediatric patients without radiation exposure. Our method is highly reliable, even among users with minimal image processing or 3D modeling experience. Our protocol can potentially be used to track treatment progress in children with chest wall deformities.
漏斗胸和鸡胸是儿科最常见的两种胸壁畸形。这些病症的标准诊断评估包括胸部X光片(CXR)或计算机断层扫描(CT)。我们的研究旨在开发一种在临床环境中无需辐射暴露就能量化胸壁畸形的新颖且可靠的方法。
我们使用手持式结构光扫描仪,通过一项经机构审查委员会批准的方案,创建了胸壁畸形患者的三维(3D)模型。然后要求来自各种背景的评估者使用商用3D图形软件根据3D模型进行测量。接着计算测量值的标准差和组内相关系数(ICC)以量化评估者间的可靠性。
60例漏斗胸(哈勒指数范围为2.0 - 6.38)和鸡胸患者在我们的门诊使用结构光扫描仪进行了登记和成像。5例患者用于验证用户间的可靠性。所有测量值的标准差为2.2毫米。绝对一致性的ICC为0.99139,1.0表示完全相关。
结构光扫描仪为在无辐射暴露的情况下量化儿科患者胸壁畸形提供了一种替代方法。我们的方法高度可靠,即使在图像处理或3D建模经验极少的用户中也是如此。我们的方案有可能用于跟踪胸壁畸形儿童的治疗进展。