Magnetic Resonance Imaging Versus 3-Dimensional Laser Scanning for Breast Volume Assessment After Breast Reconstruction

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To the Editor:
We meticulously read the recent article titled “Magnetic resonance imaging versus 3-dimensional laser scanning for breast volume assessment after breast reconstruction” by Howes et al.1 in Annals of Plastic Surgery. In this article, the authors did a great job comparing 3-dimensional (3D) laser scanning and noncontrast magnetic resonance imaging (MRI) for measuring breast volume in women undergoing breast reconstruction using autologous fat grafting and finding that 3D laser scanning was equivalent to noncontrast MRI. Inspired by the author, we would like to express some opinions.
First, based on this article, we can know that patients received MRI scan in a prone position or 3D laser scan in a standing position for measuring breast volume. However, the breast volume may vary with positions. The study of Chen et al2 demonstrated that body position had an impact on the measurement of breast volume using MRI. Similarly, the other study found that the accuracy of 3D laser scanner varied with positions.3 Thus, would it be better to restrict the patients in the same position for measuring breast volume when using different methods to compare?
Second, aside from the pose effect, the state of respiration also affected the volumetric measurement of breasts.4 To increase the accuracy of breast volumetric measurement, it will be helpful to keep the respiration state constant during the process of scanning.
Third, the author stated that because of the breast tissue susceptible to gravity, the accuracy of MRI scanner on breast volume will be compromised. In addition, from our experience, because of the restriction of the fixed shape and size of MRI scanner coils, the breast volume is bound to be affected, especially for the large breasts. That may be another factor affecting the accuracy of MRI on the measurement of breast volume.

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