Objective evaluation of volumetric changes during breast augmentation using intraoperative three-dimensional surface imaging.

BACKGROUND: Breast volume estimation and implant size are crucial factors to achieve a symmetrical result in esthetic and reconstructive breast surgery. Although three-dimensional surface imaging (3DSI) has allowed for a better understanding of breast shape, size, and asymmetry during patient consultation, its use has been limited regarding intraoperative decision-making. OBJECTIVE: To validate the intraoperative use of a portable hand-held 3D surface imaging device as an objective tool to assess volumetric changes during breast augmentation surgery. METHODS: Patients receiving bilateral, submuscular breast augmentation were enrolled for this study. Intraoperative 3DSI was conducted using the Sense 3D scanner, allowing for digitalization of the operating field. Intraoperatively gauged volume changes caused by known implant volumes were compared with digital measurements calculated from 3D surface images of the operating field. Digital intraoperative breast volumes were compared to the pre- and postoperative Vectra XT reference system. RESULTS: Eighty individual breasts of 40 patients were successfully 3D imaged before incision and after wound closure. There was no significant difference between digital breast volumes by intraoperative and outpatient 3DSI. Intraoperative pre- to postoperative 3D breast volume change showed no significant difference to the known implant volume (p = 0.124, mean deviation of 5.8 ± 24.3 mL and 2.0 ± 9.0%). CONCLUSIONS: Our findings showed a high correlation regarding intraoperative digital breast volumetric changes. Intraoperative use of 3DSI yielded objective data during breast augmentation. This novel technique could beneficially impact future breast implant selection, especially in cases with breast asymmetry and the need for differently sized implants.

Development of an automated turbidimetric immunoassay for quantification of bovine serum immunoglobulin G.

OBJECTIVE: To develop an automated turbidimetric immunoassay (TIA) for measurement of bovine IgG. SAMPLE POPULATION: 24 bovine serum samples. PROCEDURE: IgG concentration was determined by use of the TIA, and results were compared with those of the radial immunodiffusion (RID) method. Variables were determined, using commercially available reagents and a clinical biochemical analyzer. For the TIA, polyclonal goat anti-bovine IgG (Fc specific) serum, bovine IgG calibrator serum, and polyethylene glycol reaction buffer were used. Sample concentrations were determined by the instrument, using the linear regression method of least squares. The accuracy of this assay was validated by referencing to a purified bovine IgG standard and by recovery of control standards. Parallelism was documented by assay linearity and serial sample dilution linearity. Interference resulting from hemolyzed samples was examined. RESULTS: The TIA method correlated positively (r = 0.9957) and significantly (P < 0.05) with the RID method, yielding a regression equation with slope of 0.78708 and y-intercept of 1.02102. Bias attributable to hemolysis was not observed. CONCLUSIONS: The TIA method is automated, accurate, and precise for bovine serum IgG quantification. CLINICAL RELEVANCE: This assay provides sample results in approximately 10 minutes and may be used as an alternative to the manual RID method.