Kim Jiwoo, Matsumine Hajime, Niimi Yosuke, Osada Atsuyoshi, Sakurai Hiroyuki
From the Department of Plastic and Reconstructive Surgery, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2023 Aug 11;11(8):e5180. doi: 10.1097/GOX.0000000000005180. eCollection 2023 Aug.
Preoperative prediction of breast volume is very important in planning breast reconstruction. In this study, we assessed the usefulness of a novel method for preoperative estimation of mastectomy volume by comparing the weight of actual mastectomy specimens with the values predicted by the developed method using the Vectra H2.
All patients underwent skin-sparing mastectomy and immediate autologous breast reconstruction. Preoperatively, the patient's breast was scanned using the Vectra H2 and a postmastectomy simulation image was constructed on a personal computer. The estimated mastectomy volume was calculated by comparing the preoperative and postmastectomy three-dimensional simulation images. Correlation coefficients with the estimated mastectomy volume were calculated for the actual mastectomy weight and the transplanted flap weight.
Forty-five breasts of 42 patients were prospectively analyzed. The correlations with the estimated mastectomy volume were r = 0.95 ( < 0.0001) for actual mastectomy weight and r = 0.84 ( < 0.0001) for transplanted free-flap weight. The mastectomy weight estimation formula obtained by linear regression analysis using the estimated mastectomy volume was 0.98 × estimated mastectomy volume + 5.4 (coefficient of determination R = 0.90, < 0.0001). The root-mean-square error for the mastectomy weight estimation formula was 38 g.
We used the Vectra H2 system to predict mastectomy volume. The predictions provided by this method were highly accurate. Three-dimensional imaging is a noncontact, noninvasive measurement method that is both accurate and simple to perform. Use of this effective tool for volume prediction is expected to increase in the future.
术前预测乳房体积在乳房重建规划中非常重要。在本研究中，我们通过比较实际乳房切除标本的重量与使用Vectra H2开发的方法预测的值，评估了一种术前估计乳房切除体积的新方法的有效性。
所有患者均接受保乳皮肤乳房切除术及即刻自体乳房重建。术前，使用Vectra H2对患者乳房进行扫描，并在个人电脑上构建乳房切除术后模拟图像。通过比较术前和乳房切除术后的三维模拟图像计算估计的乳房切除体积。计算实际乳房切除重量和移植皮瓣重量与估计乳房切除体积的相关系数。
对42例患者的45个乳房进行了前瞻性分析。实际乳房切除重量与估计乳房切除体积的相关系数r = 0.95（<0.0001），移植游离皮瓣重量与估计乳房切除体积的相关系数r = 0.84（<0.0001）。使用估计乳房切除体积通过线性回归分析得到的乳房切除重量估计公式为0.98×估计乳房切除体积 + 5.4（决定系数R = 0.90，<0.0001）。乳房切除重量估计公式的均方根误差为38 g。
我们使用Vectra H2系统预测乳房切除体积。该方法提供的预测高度准确。三维成像为非接触、非侵入性测量方法，准确且易于操作。预计未来这种有效的体积预测工具的使用将会增加。
