MRI-based breast volumetry-evaluation of three different software solutions

Abstract

As lipofilling of the female breast is becoming more popular in plastic surgery, the use of MRI to assess breast volume has been employed to control postoperative results. Therefore, we sought to evaluate the accuracy of magnetic resonance imaging (MRI)-based breast volumetry software tools by comparing the measurements of silicone implant augmented breasts with the actual implant volume specified by the manufacturer. MRI-based volume analysis was performed in eight bilaterally augmented patients (46 ± 9 years) with three different software programs (Brainlab© I plan 2.6 neuronavigation software; mass analysis, version 5.3, Medis©; and OsiriX© v.3.0.2. 32-bit). The implant volumes analysed by the BrainLab© software had a mean deviation of 2.2 ± 1.7% (r = 0.99) relative to the implanted prosthesis. OsiriX© software analysis resulted in a mean deviation of 2.8 ± 3.0% (r = 0.99) and the Medis© software had a mean deviation of 3.1 ± 3.0% (r = 0.99). Overall, the volumes of all analysed breast implants correlated very well with the real implant volumes. Processing time was 10 min per breast with each system and 30 s (OsiriX©) to 5 min (BrainLab© and Medis©) per silicone implant. MRI-based volumetry is a powerful tool to calculate both native breast and silicone implant volume in situ. All software solutions performed well and the measurements were close to the actual implant sizes. The use of MRI breast volumetry may be helpful in: (1) planning reconstructive and aesthetic surgery of asymmetric breasts, (2) calculating implant size in patients with missing documentation of a previously implanted device and (3) assessing post-operative results objectively.

Fig 1

MRI breast volumetry using Brainlab© I plan 2.6 neuronavigation software, installed on a Windows computer. The entire augmented breast with the elliptical silicone implant in situ is traced. The upper left window contains a 3D reconstruction.

Fig 2

MRI breast volumetry using Mass analysis, version 5.3, Medis©. The silicon breast implant (elliptical area) is traced onto axial slices.

Fig 3

MRI breast volumetry using OsiriX© v.3.0.2. 32-bit. The breasts with the elliptical silicone implant inside are traced on a bilateral axial slice. After marking all slices, the volume is calculated by the software.

Fig 4

Implant volumes determined by all three software packages were positively correlated with the volumes indicated in the official implant dimensions (Pearson correlation coefficient r = 0.99). No differences were observed between the different software tools (p = 0.516).

Fig 5

Correlation of breast volume. Pearson correlation coefficient of all analyses was r = 0.99.