Abstract P378: Automated Estimation of Ischemic Core Volume on Non-Contrast-Enhanced Computed Tomography via Machine Learning

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
IRIS E CHEN ◽  
Brian Tsui ◽  
Joe X Qiao ◽  
William Hsu ◽  
Latisha K Sharma ◽  
...  
Keyword(s):  
Machine Learning ◽  
Diffusion Mri ◽  
Pearson Correlation ◽  
Accurate Estimation ◽  
Lesion Volume ◽  
Reference Standard ◽  
Ischemic Lesion ◽  
The Mean ◽  
Ischemic Core ◽  
Core Volume

Background and Purpose: Accurate estimation of ischemic core on baseline imaging has treatment implications in patients with acute ischemic stroke (AIS). Machine learning (ML) algorithms have shown promising results in estimating ischemic core using routine non-contrast CT (NCCT). We used a ML-trained algorithm to quantify ischemic core volume on NCCT and compared the results to concurrent diffusion MRI as the reference standard in patients with AIS. Methods: We analyzed consecutive anterior circulation AIS patients who had baseline (pretreatment) NCCT and MRI (DWI). Ischemic lesion volume was calculated on MRI-DWI using an automated software (Olea Medical SAS, La Ciotat, France). An automatic segmentation approach using a combination of traditional 3D graphics and statistical methods, and ML classification techniques (Brainomix, Oxford, United Kingdom) was used to identify ischemic core voxels on NCCT. Total ischemic core volumes on ML-NCCT and DWI-MR were quantitatively compared by Bland-Altman plots and Pearson correlation. Results: A total of 50 patients (27 female, 23 male, mean age 72.6 years) were included. Baseline imaging was performed within 173 ± 143 minutes (mean ± SD) from symptom onset. The mean time difference between MRI and NCCT was 72 min. The baseline NIHSS was 14, 8-21 (Median, IQR). Algorithm-segmented ischemic core volume detected on NCCT was median 12.7 mL, IQR 3.5-26.0 mL. Ischemic core volume on DWI MRI was median 8.8 mL, IQR 3.2-34.0 mL. ML-NCCT core volumes significantly correlated with DWI MRI core volumes, r =0.61, p <0.001. The mean difference between the ML-NCCT and DWI MRI core volumes was 12.4 mL, p =0.81. For the reperfusion treatment threshold of an ischemic core volume within 70 mL, while no patients would have been excluded using our algorithm, five patients would have been incorrectly dichotomized as having an ischemic volume of <70 mL compared to MRI. Conclusion: This ML-approach accurately quantifies ischemic core volume on NCCT compared to the reference standard of diffusion MRI in patients with AIS.

scholarly journals Ischemic lesion growth in acute stroke: Water uptake quantification distinguishes between edema and tissue infarct

2019 ◽  
Vol 40 (4) ◽  
pp. 823-832 ◽  
Author(s):  
Gabriel Broocks ◽  
Uta Hanning ◽  
Tobias D Faizy ◽  
Alexandra Scheibel ◽  
Jawed Nawabi ◽  
...  
Keyword(s):  
Water Uptake ◽  
Treatment Effects ◽  
Vasogenic Edema ◽  
Outcome Variable ◽  
Lesion Volume ◽  
Ischemic Lesion ◽  
Lesion Growth ◽  
The Mean ◽  
Ischemic Core ◽  
Core Volume

Infarct growth from the early ischemic core to the total infarct lesion volume (LV) is often used as an outcome variable of treatment effects, but can be overestimated due to vasogenic edema. The purpose of this study was (1) to assess two components of early lesion growth by distinguishing between water uptake and true net infarct growth and (2) to investigate potential treatment effects on edema-corrected net lesion growth. Sixty-two M1-MCA-stroke patients with acute multimodal and follow-up CT (FCT) were included. Ischemic lesion growth was calculated by subtracting the initial CTP-derived ischemic core volume from the LV in the FCT. To determine edema-corrected net lesion growth, net water uptake of the ischemic lesion on FCT was quantified and subtracted from the volume of uncorrected lesion growth. The mean lesion growth without edema correction was 20.4 mL (95% CI: 8.2–32.5 mL). The mean net lesion growth after edema correction was 7.3 mL (95% CI: −2.1–16.7 mL; p < 0.0001). Lesion growth was significantly overestimated due to ischemic edema when determined in early-FCT imaging. In 18 patients, LV was lower than the initial ischemic core volume by CTP. These apparently “reversible” core lesions were more likely in patients with shorter times from symptom onset to imaging and higher recanalization rates.

scholarly journals High Speed Diffusion Magnetic Resonance Imaging of Ischemia and Spontaneous Periinfarct Spreading Depression after Thromboembolic Stroke in the Rat

2000 ◽  
Vol 20 (12) ◽  
pp. 1636-1647 ◽  
Author(s):  
Andreas Kastrup ◽  
Tobias Neumann-Haefelin ◽  
Michael E. Moseley ◽  
Alex de Crespigny
Keyword(s):  
Temporal Resolution ◽  
High Speed ◽  
Spreading Depression ◽  
Tissue Injury ◽  
Lesion Volume ◽  
Thromboembolic Stroke ◽  
Ischemic Lesion ◽  
Intracellular Space ◽  
Ischemic Core

Spontaneous episodes of transient cell membrane depolarization (spreading depression [SD]) occur in the surroundings of experimental stroke lesions and are believed to contribute to infarct growth. Diffusion-weighted imaging (DWI) is capable of detecting the water shifts from extracellular to intracellular space associated with SD waves and ischemia, and can make in vivo measurements of these two features on a pixel-by-pixel basis with good temporal resolution. Using continuous high speed DWI with a temporal resolution of 12 seconds over a period of 3 hours, the in vivo contribution of spontaneous SDs to the development of ischemic tissue injury was examined in 8 rats using a thromboembolic stroke model. During the observation period, the initial lesion volume increased in 4 animals, remained unchanged in 1 animal, and decreased in 3 animals (most likely because of spontaneous clot lysis). Irrespective of the lesion evolution patterns, animals demonstrated 6.5 ± 2.1 spontaneous SDs outside of the ischemic core. A time-to-peak analysis of apparent diffusion coefficient (ADC) changes for each SD wave demonstrated multidirectional propagation patterns from variable initiation sites. Maps of the time constants of ADC recovery, reflecting the local energy supply and cerebral blood flow, revealed prolonged recovery times in areas close to the ischemic core. However, repetitive SD episodes in the periinfarct tissue did not eventually lead to permanent ADC reductions. These results suggest that spontaneous SD waves do not necessarily contribute to the expansion of the ischemic lesion volume in this model.

Abstract TP91: Unfavorable Baseline Hypoperfusion Intensity Ratio is Associated With Infarct Growth and Poor Outcome in Patients With Distal MCA Occlusions

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam MacLellan ◽  
Michael Mlynash ◽  
Stephanie Kemp ◽  
Soren Christensen ◽  
Michael Marks ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Intensity Ratio ◽  
Ct Perfusion ◽  
Anterior Circulation ◽  
Excellent Functional Outcome ◽  
The Mean ◽  
Ischemic Core ◽  
Core Volume ◽  
Distal Middle Cerebral Artery

Background: A low hypoperfusion intensity ratio (HIR) predicts good collateral vessel status and correlates with infarct growth and functional outcome in early window patients with proximal large vessel anterior circulation occlusions. Its performance in predicting clinical and radiologic outcome has not been assessed in patients with more distal occlusions. In this retrospective analysis of the CT Perfusion to Predict Response to Recanalization in Ischemic Stroke (CRISP) study, we hypothesized that a favorable baseline HIR would predict less infarct growth in patients with distal middle cerebral artery (MCA) occlusions. Methodology: Patients with occlusions of an M2 or M3 branch of the MCA on catheter angiography were included; all patients underwent mechanical thrombectomy with TICI2B/3 reperfusion. Baseline ischemic core volume and HIR (Tmax >10s / Tmax >6s) were assessed with RAPID software; late follow-up infarct volumes (>36 hours from initial CT perfusion) were manually determined from DWI MRI. Excellent functional outcome was defined as a modified Rankin score of 0-1. Results: Fourteen patients with baseline perfusion and late follow-up imaging were included; nine patients presented with M2 occlusions, and 5 with M3 occlusions. The mean baseline HIR of 0.48 was used to dichotomize patients into favorable or unfavorable baseline profiles. Patients with a favorable baseline HIR had significantly smaller baseline ischemic core volumes (0 mL [IQR 0-3.3] vs. 14.0 mL [IQR 8.7-22.1], p=0.01), smaller final infarct volumes (16.1 mL [IQR 12.7-41.2] vs. 71.4 mL [IQR 43.8-113.5], p=0.01) and less infarct growth (16.1 mL [IQR 9.4-31.9] vs. 49.0 mL [IQR 31.1-100.8], p=0.03). Excellent functional outcome was achieved in 6/6 (100%) of those with favorable baseline HIR, versus 3/8 (37.5%) with unfavorable baseline profile (p=0.03). Conclusion: In patients with distal MCA occlusions, poor collateral status at baseline as demonstrated by a high HIR score is associated with more infarct growth and worse clinical outcomes. HIR may be helpful for guiding thrombectomy decisions in patients with distal occlusions and warrants further prospective study in this population.

Exploring the relationship between ischemic core volume and clinical outcomes after thrombectomy or thrombolysis

Neurology ◽  
2019 ◽  
Vol 93 (3) ◽  
pp. e283-e292 ◽  
Author(s):  
Chushuang Chen ◽  
Mark W. Parsons ◽  
Christopher R. Levi ◽  
Neil J. Spratt ◽  
Ferdinand Miteff ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Clinical Severity ◽  
Lesion Volume ◽  
Lower Odds ◽  
Excellent Outcome ◽  
Ischemic Core ◽  
Core Volume ◽  
Excellent Clinical Outcome

ObjectiveTo assess whether complete reperfusion after IV thrombolysis (IVT-R) would result in similar clinical outcomes compared to complete reperfusion after endovascular thrombectomy (EVT-R) in patients with a large vessel occlusion (LVO).MethodsEVT-R patients were matched by age, clinical severity, occlusion location, and baseline perfusion lesion volume to IVT-R patients from the International Stroke Perfusion Imaging Registry (INSPIRE). Only patients with complete reperfusion on follow-up imaging were included. The excellent clinical outcome rates at day 90 on the modified Rankin Scale (mRS) were compared between EVT-R vs IVT-R patients within quintiles of increasing baseline ischemic core and penumbral volumes.ResultsFrom INSPIRE, there were 141 EVT-R patients and 141 matched controls (IVT-R) who met the eligibility criteria. In patients with a baseline core <30 mL, EVT-R resulted in a lower odds of achieving an excellent outcome at day 90 compared to IVT-R (day 90 mRS 0–1 odds ratio 0.01, p < 0.001). The group with a baseline core <30 mL contained mostly patients with distal M1 or M2 occlusions, and good collaterals (p = 0.01). In patients with a baseline ischemic core volume >30 mL (internal carotid artery and mostly proximal M1 occlusions), EVT-R increased the odds of patients achieving an excellent clinical outcome (day 90 mRS 0–1 odds ratio 1.61, p < 0.001) and there was increased symptomatic intracranial hemorrhage in the IVT-R group with core >30 mL (20% vs 3% in EVT-R, p = 0.008).ConclusionFrom this observational cohort, LVO patients with larger baseline ischemic cores and proximal LVO, with poorer collaterals, clearly benefited from EVT-R compared to IVT-R alone. However, for distal LVO patients, with smaller ischemic cores and better collaterals, EVT-R was associated with a lower odds of favorable outcome compared to IVT-R alone.

scholarly journals Development and validation of a machine learning, smartphone-based tonometer

2019 ◽  
Vol 104 (10) ◽  
pp. 1394-1398 ◽  
Author(s):  
Yue Wu ◽  
Ian Luttrell ◽  
Shu Feng ◽  
Philip P Chen ◽  
Ted Spaide ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intraocular Pressure ◽  
Clinical Practice ◽  
Applanation Tonometry ◽  
Goldmann Applanation Tonometry ◽  
Computer Algorithm ◽  
Reference Standard ◽  
Limits Of Agreement ◽  
The Mean ◽  
Development And Validation

Background/AimsTo compare intraocular pressure (IOP) measurements using a prototype smartphone tonometer with other tonometers used in clinical practice.MethodsPatients from an academic glaucoma practice were recruited. The smartphone tonometer uses fixed force applanation and in conjunction with a machine-learning computer algorithm is able to calculate the IOP. IOP was also measured using Goldmann applanation tonometry (GAT) in all subjects. A subset of patients were also measured using ICare, pneumotonometry (upright and supine positions) and Tono-Pen (upright and supine positions) and the results were compared.Results92 eyes of 81 subjects were successfully measured. The mean difference (in mm Hg) for IOP measurements of the smartphone tonometer versus other devices was +0.24 mm Hg for GAT, −1.39 mm Hg for ICare, −3.71 mm Hg for pneumotonometry and −1.30 mm Hg for Tono-Pen. The 95% limits of agreement for the smartphone tonometer versus other devices was −4.35 to 4.83 mm Hg for GAT, −6.48 to 3.70 mm Hg for ICare, −7.66 to −0.15 mm Hg for pneumotonometry and −5.72 to 3.12 mm Hg for Tono-Pen. Overall, the smartphone tonometer results correlated best with GAT (R2=0.67, p<0.001). Of the 92 videos, 90 (97.8%) were within ±5 mm Hg of GAT and 58 (63.0%) were within ±2 mm Hg of GAT.ConclusionsPreliminary IOP measurements using a prototype smartphone-based tonometer was grossly equivalent to the reference standard.

scholarly journals Real-time Prediction of the Daily Incidence of COVID-19 in 215 Countries and Territories Using Machine Learning: Model Development and Validation (Preprint)

2020 ◽  
Author(s):  
Yuanyuan Peng ◽  
Xinjian Chen ◽  
Yibiao Rong ◽  
Chi Pui Pang ◽  
Xinjian Chen ◽  
...  
Keyword(s):  
Machine Learning ◽  
Real Time ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Google Trends ◽  
Pearson Correlation Coefficient ◽  
Spearman Correlation ◽  
Time Prediction ◽  
Search Volume ◽  
The Mean

BACKGROUND Advanced prediction of the daily incidence of COVID-19 can aid policy making on the prevention of disease spread, which can profoundly affect people's livelihood. In previous studies, predictions were investigated for single or several countries and territories. OBJECTIVE We aimed to develop models that can be applied for real-time prediction of COVID-19 activity in all individual countries and territories worldwide. METHODS Data of the previous daily incidence and infoveillance data (search volume data via Google Trends) from 215 individual countries and territories were collected. A random forest regression algorithm was used to train models to predict the daily new confirmed cases 7 days ahead. Several methods were used to optimize the models, including clustering the countries and territories, selecting features according to the importance scores, performing multiple-step forecasting, and upgrading the models at regular intervals. The performance of the models was assessed using the mean absolute error (MAE), root mean square error (RMSE), Pearson correlation coefficient, and Spearman correlation coefficient. RESULTS Our models can accurately predict the daily new confirmed cases of COVID-19 in most countries and territories. Of the 215 countries and territories under study, 198 (92.1%) had MAEs &lt;10 and 187 (87.0%) had Pearson correlation coefficients &gt;0.8. For the 215 countries and territories, the mean MAE was 5.42 (range 0.26-15.32), the mean RMSE was 9.27 (range 1.81-24.40), the mean Pearson correlation coefficient was 0.89 (range 0.08-0.99), and the mean Spearman correlation coefficient was 0.84 (range 0.2-1.00). CONCLUSIONS By integrating previous incidence and Google Trends data, our machine learning algorithm was able to predict the incidence of COVID-19 in most individual countries and territories accurately 7 days ahead.

Abstract 16796: Machine Learning-Based Hepatic Fat Assessment in Low-Dose Coronary Artery Calcium Scans is Correlated With Human Reader Assessment

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gourav Modanwal ◽  
Jonathan R Walker ◽  
Sadeer Al-Kindi ◽  
Sanjay Rajagopalan ◽  
Anant Madabhushi
Keyword(s):  
Machine Learning ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Low Dose ◽  
Pearson Correlation ◽  
Surrogate Marker ◽  
Ct Scans ◽  
Accurate Estimation ◽  
Ct Attenuation ◽  
Hepatic Fat

Introduction: Hepatic attenuation on computed tomography (CT) is a surrogate marker for cardiometabolic risk, including Type 2 diabetes and its progression. Coronary artery calcium (CAC) screening for assessment of cardiovascular risk often includes portions of the liver and provides an opportunity for concomitant assessment of liver fat. However, the use of lower radiation dose CT and the need for reliable regions of interest (ROI) tracing creates challenges for routine clinical utilization. We present machine learning-based hepatic fat assessment (a) segmentation of liver and spleen and (b) CT attenuation measurement on low dose CT scans performed for CAC screening. Methods: Our approach (Figure 1a) comprises two steps. First, a deep learning-based model is utilized to segment the liver and spleen. Second, CT attenuation is measured on imaged organ volume. The segmentation model (U-Net with an EfficientNetB3 backbone) is trained with 5-fold cross-validation on 35 patients enrolled in the CLARIFY registry (clinicaltrials.gov NCT04075162) and validated on an independent set of 21 patients. The ground truth for segmentation is generated using Slicer 3D. Further, mean liver and mean liver-to-spleen CT attenuation is automatically measured on these scans and compared with manual ROI based assessment. Results: The segmentation model achieved a dice coefficient of 0.91 on the validation (Figure 1b). The automated volumetric assessment of liver and liver-to-spleen attenuation estimation showed a strong correlation with manual ROI assessment (Pearson correlation coefficient R=0.89 and R=0.88, respectively; Figure 1c). Conclusions: The presented machine-learning-based methods enable accurate estimation of liver and liver-to-spleen attenuation ratio on low-dose CAC CT scans. The approach needs to be further validated on larger, multi-institutional datasets to analyze its generalizability for hepatic fat assessment.

scholarly journals Validation of PET/MRI attenuation correction methodology in the study of brain tumours

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Francesca De Luca ◽  
Martin Bolin ◽  
Lennart Blomqvist ◽  
Cecilia Wassberg ◽  
Heather Martin ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Attenuation Correction ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Proton Density ◽  
Reference Standard ◽  
Hotspot Analysis ◽  
Positron Emission ◽  
The Mean ◽  
Mirror Region

Abstract Background This study aims to compare proton density weighted magnetic resonance imaging (MRI) zero echo time (ZTE) and head atlas attenuation correction (AC) to the reference standard computed tomography (CT) based AC for 11C-methionine positron emission tomography (PET)/MRI. Methods A retrospective cohort of 14 patients with suspected or confirmed brain tumour and 11C-Methionine PET/MRI was included in the study. For each scan, three AC maps were generated: ZTE–AC, atlas-AC and reference standard CT-AC. Maximum and mean standardised uptake values (SUV) were measured in the hotspot, mirror region and frontal cortex. In postoperative patients (n = 8), SUV values were additionally obtained adjacent to the metal implant and mirror region. Standardised uptake ratios (SUR) hotspot/mirror, hotspot/cortex and metal/mirror were then calculated and analysed with Bland–Altman, Pearson correlation and intraclass correlation reliability in the overall group and subgroups. Results ZTE–AC demonstrated narrower SD and 95% CI (Bland–Altman) than atlas-AC in the hotspot analysis for all groups (ZTE overall ≤ 2.84, − 1.41 to 1.70; metal ≤ 1.67, − 3.00 to 2.20; non-metal ≤ 3.04, − 0.96 to 3.38; Atlas overall ≤ 4.56, − 1.05 to 3.83; metal ≤ 3.87, − 3.81 to 4.64; non-metal ≤ 4.90, − 1.68 to 5.86). The mean bias for both ZTE–AC and atlas-AC was ≤ 2.4% compared to CT-AC. In the metal region analysis, ZTE–AC demonstrated a narrower mean bias range—closer to zero—and narrower SD and 95% CI (ZTE 0.21–0.48, ≤ 2.50, − 1.70 to 2.57; Atlas 0.56–1.54, ≤ 4.01, − 1.81 to 4.89). The mean bias for both ZTE–AC and atlas-AC was within 1.6%. A perfect correlation (Pearson correlation) was found for both ZTE–AC and atlas-AC compared to CT-AC in the hotspot and metal analysis (ZTE ρ 1.00, p < 0.0001; atlas ρ 1.00, p < 0.0001). An almost perfect intraclass correlation coefficient for absolute agreement was found between Atlas-, ZTE and CT maps for maxSUR and meanSUR values in all the analyses (ICC > 0.99). Conclusions Both ZTE and atlas-AC showed a good performance against CT-AC in patients with brain tumour.

scholarly journals Value of Combination of Standard Axial and Thin-Section Coronal Diffusion-weighted Imaging in Diagnosis of Acute Brainstem Infarction

2019 ◽  
Vol 7 (14) ◽  
pp. 2287-2291 ◽  
Author(s):  
Nashwan I. Khaleel ◽  
Muna A. G. Zghair ◽  
Qays A. Hassan
Keyword(s):  
Thin Section ◽  
Medulla Oblongata ◽  
Cross Sectional Study ◽  
Lesion Volume ◽  
Mri Findings ◽  
Brainstem Infarction ◽  
Cross Sectional ◽  
Ischemic Lesion ◽  
Mri Protocol ◽  
The Mean

AIM: To determine the value of the combination of thin-section 3 mm ‎coronal and standard ‎axial DWI and their impact in facilitating the diagnosis of ‎‎acute brainstem infarction. METHODS: A cross-sectional study conducted from the 1st of April 2017 to the end of February 2018 on 100 consecutive patients (66% were male, and 34% were female) with isolated acute ischemic infarction in the ‎brainstem. The abnormal MRI findings concerning the ischemic lesions were interpreted on standard axial 5 mm and thin-section coronal 3mm DWI. RESULTS: The mean age of the studied group was 69.2 ± 4.3 for male and 72.3 ± 2.5 years. The standard axial DWI can diagnose 20%, 6.7% and 6.7% of the infarctions in midbrain, pons and medulla oblongata respectively, while both axial and thin coronal sections together can diagnose 80% of midbrain infarctions, 93.3% of pons infarctions and 93.3% of medulla oblongata infarctions. Furthermore, the thin section coronal 3 mm section can diagnose very smaller ischemic lesion volume in comparison to the standard axial 5mm section (3.4 ± 0.45 / cm3 versus 4.6 ± 0.23 / cm3, P < 0.001) CONCLUSION: The addition of thin-section coronal DWI can facilitate the detection of brainstem ischemic lesions. We suggest its inclusion in the stroke MRI protocol.

Accurate Assessment of Breast Volume by Computed Tomography Using Three-dimensional Imaging Device

2012 ◽  
Vol 78 (9) ◽  
pp. 933-935 ◽  
Author(s):  
Takaaki Fujii ◽  
Satoru Yamaguchi ◽  
Reina Yajima ◽  
Soichi Tsutsumi ◽  
Takayuki Asao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Pearson Correlation ◽  
Three Dimensional ◽  
Preoperative Assessment ◽  
Immediate Breast Reconstruction ◽  
Accurate Estimation ◽  
Breast Volume ◽  
Imaging Device ◽  
The Mean

Preoperative assessment of breast volume could contribute significantly to the planning of breast reconstructive surgery. However, breast volume measurements are not carried out on a routine basis, because there is still no commonly accepted standard method for such measurements. In the current study, we assessed whether routine computed tomography (CT) of the chest using a three-dimensional device could provide accurate estimation of breast volumes in patients with breast cancer. Ten consecutive patients and 11 breasts with breast cancer that underwent mastectomy with immediate breast reconstruction were enrolledin this study. Ineach case, a three-dimensional image was constructed according to the CT data using a volume-rendering technique. Computed breast volumes were compared with known breast volumes obtained from surgical specimens. The mean breast volume of surgical specimens was 324.1 ± 173.5 mL. The mean breast volume value was established to be 351.6 ± 174.3 mL with three-dimensional CT in a novel method. There was a strong linear association between breast volumes of surgical specimens and breast volumes measured by the three-dimensional CT method when using a Pearson correlation (r = 0.985, P < 0.001). Our results suggest that the calculation of breast volume using three-dimensional CT is accurate enough to have a significant clinical benefit in planning reconstructive breast surgery. This method can help the surgeon predict the esthetic effect of various breast surgeries and guide the choice of the most appropriate implant preoperatively.

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