3D volumetric analysis and haptic modeling for preoperative planning in breast reconstruction

Background: Preoperative planning and imaging have shown improved clinical outcome inbreast reconstructions. However, an accurate, objective method of volumetricanalysis has eluded investigators in the past. Furthermore, scan data from the current imaging modality are limited by the two dimensional (2D) representation on a computer screen. The introduction of 3D haptic biomodeling has led to a more intuitive understanding of the relationship between anatomical structures. Method:We describe an easy, reproducible, accessible approach to volumetric analysis of the breast, by 3Dprinting a haptic model from the scan data. This approach comprises use of a single computed tomography (CT) or magnetic resonance imaging(MRI) scan for volumetric analysis, which we use to compare to simpler estimation techniques, create software-generated 3D reconstructions, calculate and visualize volume differences, and produce biomodels of the breasts using a 3D printer for tactile appreciation of volume differential. Results: Using the technique described, parenchymal volume was assessed and calculated using CT data. Two cases of breast asymmetry were utilized in a pictorial account of the technique, in which a volume difference of 116cm3 and 124.61 cm3 respectively was calculated, aiding reconstructive planning. Conclusion: Preoperative planning can improve aesthetic and clinical outcomes in breast reconstruction by achieving symmetry, reducing operative length and complications. We demonstrate that our technique of volumetric analysis and the production of 3D haptic biomodels will be a valuable addition to the current array of preoperative planning tools. Our findings warrant a further evaluation of the technique for correlation with clinical outcomes through trials.