title: The Kinect Recording System for objective three- and four-dimensional breast assessment with image overlays.
abstract: BACKGROUND
  We investigated the application of the validated portable Kinect camera for three- and four-dimensional breast assessment in female life models.
  
  
  METHODS
  Breast images from six life models were captured using the Kinect camera. Capture was conducted with taking three different arm positions while standing upright: with the arms straight down, straight up to the side at 90° and straight all the way up. Images of the volunteers were superimposed on each other. Digital linear distances between sternal notch and nipple-areola complexes were obtained and compared. The views of plastic and breast surgeons to arm positions were questioned. An example for clinical application was provided.
  
  
  RESULTS
  Successful capture of images of the female life breast models was achieved. Digital breast measurements at the three different arm positions revealed considerable variation in linear distances measured on the images obtained with the Kinect camera. The dynamic of breast movements could be demonstrated by image overlay and the first ever four-dimensional breast assessment was demonstrated. Fourteen plastic and breast surgeons were found to have nine different opinions regarding their favoured arm positions for breast capture. Even though precision of image sharpness still needs improvement, the images were satisfactory for clinical patient use. The Kinect data were shown to be applicable to surgery planning by designing a planar flap from the 3D mesh.
  
  
  CONCLUSIONS
  The portable and low-cost Kinect camera proved to be easy to use for the first application in life models for three- and four-dimensional breast assessment.
authors.affiliation: Medical School of Hannover (Medizinische Hochschule Hannover), Department of Plastic-, Hand- and Reconstructive Surgery, Germany. Electronic address: henseler.helga@mh-hannover.de.
authors.forename: Helga
authors.initials: H
authors.lastname: Henseler
authors.affiliation: Medical School of Hannover (Medizinische Hochschule Hannover), Department of Plastic-, Hand- and Reconstructive Surgery, Germany. Electronic address: SarahKimBonkat@gmx.de.
authors.forename: Sarah Kim
authors.initials: SK
authors.lastname: Bonkat
authors.affiliation: Medical School of Hannover (Medizinische Hochschule Hannover), Department of Plastic-, Hand- and Reconstructive Surgery, Germany. Electronic address: vogt.peter@mh-hannover.de.
authors.forename: Peter Maria
authors.initials: PM
authors.lastname: Vogt
authors.affiliation: Institute for Information Processing, Department of Computer Science and Electrical Engineering, Leibniz University of Hannover, Germany. Electronic address: Rosenhahn@tnt.uni-hannover.de.
authors.forename: Bodo
authors.initials: B
authors.lastname: Rosenhahn
mesh_terms: D001940:Breast / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D009929:Organ Size; D011187:Posture; D015203:Reproducibility of Results; D012984:Software
keywords: Arm positioning; Breast assessment; Flap planning; Kinect; Objective method; Three-dimensional imaging