Pham My, Alzul Robert, Elder Elisabeth, French James, Cardoso Jaime, Kaviani Ahmad, Meybodi Farid
Westmead Breast Institute, Westmead, NSW, Australia.
Department of Engineering, University of Porto, Porto, Portugal.
Aesthetic Plast Surg. 2023 Feb;47(1):1-7. doi: 10.1007/s00266-022-03087-z. Epub 2022 Sep 23.
Breast symmetry is an essential component of breast cosmesis. The Harvard Cosmesis scale is the most widely adopted method of breast symmetry assessment. However, this scale lacks reproducibility and reliability, limiting its application in clinical practice. The VECTRA® XT 3D (VECTRA®) is a novel breast surface imaging system that, when combined with breast contour measuring software (Mirror®), aims to produce a more accurate and reproducible measurement of breast contour to aid operative planning in breast surgery.
This study aims to compare the reliability and reproducibility of subjective (Harvard Cosmesis scale) with objective (VECTRA®) symmetry assessment on the same cohort of patients.
Patients at a tertiary institution had 2D and 3D photographs of their breasts. Seven assessors scored the 2D photographs using the Harvard Cosmesis scale. Two independent assessors used Mirror® software to objectively calculate breast symmetry by analysing 3D images of the breasts.
Intra-observer agreement ranged from none to moderate (kappa - 0.005-0.7) amongst the assessors using the Harvard Cosmesis scale. Inter-observer agreement was weak (kappa 0.078-0.454) amongst Harvard scores compared to VECTRA® measurements. Kappa values ranged 0.537-0.674 for intra-observer agreement (p < 0.001) with Root Mean Square (RMS) scores. RMS had a moderate correlation with the Harvard Cosmesis scale (r = 0.613). Furthermore, absolute volume difference between breasts had poor correlation with RMS (R = 0.133).
VECTRA® and Mirror® software have potential in clinical practice as objectifying breast symmetry, but in the current form, it is not an ideal test.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
乳房对称性是乳房美容的重要组成部分。哈佛美容量表是应用最广泛的乳房对称性评估方法。然而,该量表缺乏可重复性和可靠性,限制了其在临床实践中的应用。VECTRA® XT 3D(VECTRA®)是一种新型的乳房表面成像系统,与乳房轮廓测量软件(Mirror®)结合使用时,旨在更准确、可重复地测量乳房轮廓,以辅助乳房手术的手术规划。
本研究旨在比较主观(哈佛美容量表)与客观(VECTRA®)对称性评估在同一组患者中的可靠性和可重复性。
一家三级医疗机构的患者拍摄了乳房的二维和三维照片。7名评估者使用哈佛美容量表对二维照片进行评分。两名独立评估者使用Mirror®软件,通过分析乳房的三维图像客观计算乳房对称性。
使用哈佛美容量表的评估者之间,观察者内一致性从无到中等(kappa值为 -0.005至0.7)。与VECTRA®测量结果相比,哈佛评分之间的观察者间一致性较弱(kappa值为0.078至0.454)。观察者内一致性的kappa值在0.537至0.674之间(p < 0.001),采用均方根(RMS)评分。RMS与哈佛美容量表有中度相关性(r = 0.613)。此外,两侧乳房的绝对体积差异与RMS的相关性较差(R = 0.133)。
VECTRA®和Mirror®软件在临床实践中具有客观化乳房对称性的潜力,但就目前形式而言,它并非理想的检测方法。
证据水平IV:本期刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266。