Skip to main content

Advertisement

Springer Nature Link
Log in

Pectus Carinatum: a non-invasive and objective measurement of severity

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

To date, standard methods for assessing the severity of chest wall deformities are mostly linked to X-ray and CT scans. However, the use of radiations limits their use when there is a need to monitor the development of the pathology over time. This is particularly important when dealing with patients suffering from Pectus Carinatum, whose treatment mainly requires the use of corrective braces and a systematic supervision. In recent years, the assessment of severity of chest deformities by means of radiation-free devices became increasingly popular but not yet adopted as standard clinical practice. The present study aims to define an objective measure by defining a severity index (named External Pectus Carinatum Index) used to monitor the course of the disease during treatment. Computed on the optical acquisition of the patients’ chest by means of an appositely devised, fast and easy-to-use, body scanner, the proposed index has been validated on a sample composed of a control group and a group of Pectus Carinatum patients. The index proved to be reliable and accurate in the characterization of the pathology, enabling the definition of a threshold that allows to distinguish the cases of patients with PC from those of healthy subjects.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Nuss D, Kelly RE (2014) The minimally invasive repair of pectus excavatum. Oper Tech Thorac Cardiovasc Surg 19:324–347. https://doi.org/10.1053/J.OPTECHSTCVS.2014.10.003

    Article  Google Scholar 

  2. Goretsky MJ, Kelly RE, Croitoru D, Nuss D (2004) Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med Clin 15:455–471

    Article  PubMed  Google Scholar 

  3. Park CH, Kim TH, Haam SJ, Jeon I, Lee S (2014) The etiology of pectus carinatum involves overgrowth of costal cartilage and undergrowth of ribs. J Pediatr Surg 49:1252–1258. https://doi.org/10.1016/J.JPEDSURG.2014.02.044

    Article  PubMed  Google Scholar 

  4. (2012) American Pediatric Surgical Association Pectus Carinatum Guideline

  5. Lain A, Garcia L, Gine C, Tiffet O, Lopez M (2017) New Methods for Imaging Evaluation of Chest Wall Deformities. Front Pediatr 5:257. https://doi.org/10.3389/fped.2017.00257

    Article  PubMed  PubMed Central  Google Scholar 

  6. Uccheddu F, Ghionzoli M, Volpe Y, Servi M, Furferi R, Governi L, Facchini F, Lo Piccolo R, McGreevy KS, Martin A, Carfagni M, Messineo A (2018) A novel objective approach to the external measurement of pectus excavatum severity by means of an optical device. Ann Thorac Surg 106:221–227. https://doi.org/10.1016/J.ATHORACSUR.2018.02.024

    Article  PubMed  Google Scholar 

  7. Egan JC, DuBois JJ, Morphy M et al (2000) Compressive orthotics in the treatment of asymmetric pectus carinatum: a preliminary report with an objective radiographic marker. J Pediatr Surg 35:1183–1186

    Article  CAS  PubMed  Google Scholar 

  8. Stephenson JT, Du Bois J (2008) Compressive orthotic bracing in the treatment of pectus carinatum: the use of radiographic markers to predict success. J Pediatr Surg 43:1776–1780. https://doi.org/10.1016/j.jpedsurg.2008.03.049

    Article  PubMed  Google Scholar 

  9. Kim HC, Park HJ, Ham SY, Nam KW, Choi SY, Oh JS, Choi H, Jeong GS, Park SW, Kim MG, Sun K (2008) Development of automatized new indices for radiological assessment of chest-wall deformity and its quantitative evaluation. Med Biol Eng Comput 46:815–823. https://doi.org/10.1007/s11517-008-0367-2

    Article  CAS  PubMed  Google Scholar 

  10. Kim HC, Park HJ, Nam KW, Kim SM, Choi EJ, Jin S, Lee JJ, Park SW, Choi H, Kim MG (2010) Fully automatic initialization method for quantitative assessment of chest-wall deformity in funnel chest patients. Med Biol Eng Comput 48:589–595. https://doi.org/10.1007/s11517-010-0612-3

    Article  CAS  PubMed  Google Scholar 

  11. Kim HC, Choi H, Jin SO, Lee JJ, Nam KW, Kim IY, Nam KC, Park HJ, Lee KH, Kim MG (2013) New computerized indices for quantitative evaluation of depression and asymmetry in patients with Chest Wall deformities. Artif Organs 37:712–718. https://doi.org/10.1111/aor.12085

    Article  PubMed  Google Scholar 

  12. Kim HC, Park MS, Lee SK, Nam KC, Park HJ, Kim MG, Song JJ, Choi H (2015) Normalized mean shapes and reference index values for computerized quantitative assessment indices of Chest Wall deformities. J Korean Phys Soc 67:1868–1875. https://doi.org/10.3938/jkps.67.1868

    Article  Google Scholar 

  13. Ewert F, Syed J, Wagner S, Besendoerfer M, Carbon RT, Schulz-Drost S (2017) Does an external chest wall measurement correlate with a CT-based measurement in patients with chest wall deformities? J Pediatr Surg 52:1583–1590. https://doi.org/10.1016/j.jpedsurg.2017.04.011

    Article  PubMed  Google Scholar 

  14. Poncet P, Kravarusic D, Richart T, Evison R, Ronsky JL, Alassiri A, Sigalet D (2007) Clinical impact of optical imaging with 3-D reconstruction of torso topography in common anterior chest wall anomalies. J Pediatr Surg 42:898–903. https://doi.org/10.1016/j.jpedsurg.2006.12.070

    Article  PubMed  Google Scholar 

  15. Open source drivers for the kinect for windows v2 device. https://github.com/OpenKinect/libfreenect2. Accessed 19 Jun 2018

  16. Gonzalez-Jorge H, Rodríguez-Gonzálvez P, Martínez-Sánchez J, González-Aguilera D, Arias P, Gesto M, Díaz-Vilariño L (2015) Metrological comparison between Kinect I and Kinect II sensors. Measurement 70:21–26. https://doi.org/10.1016/J.MEASUREMENT.2015.03.042

    Article  Google Scholar 

  17. Kuru P, Cakiroglu A, Er A, Ozbakir H, Cinel AE, Cangut B, Iris M, Canbaz B, Pıçak E, Yuksel M (2016) Pectus excavatum and pectus Carinatum: associated conditions, family history, and postoperative patient satisfaction. Korean J Thorac Cardiovasc Surg 49:29–34. https://doi.org/10.5090/kjtcs.2016.49.1.29

    Article  PubMed  PubMed Central  Google Scholar 

  18. Glinkowski W, Sitnik R, Witkowski M, Kocoń H, Bolewicki P, Górecki A (2009) Method of pectus excavatum measurement based on structured light technique. J Biomed Opt 14:044041. https://doi.org/10.1117/1.3210782

    Article  PubMed  Google Scholar 

  19. Izenman AJ (2013) Linear discriminant analysis. Springer, New York, pp 237–280

    Google Scholar 

  20. Minitab. http://www.minitab.com/en-us/. Accessed 14 Jan 2019

Download references

Acknowledgments

We would like to express our utmost gratitude to Federico Tinti for his invaluable help with the whole process.

Author information

Authors and Affiliations

  1. Department of Industrial Engineering, University of Florence, Via di Santa Marta 3, 50139, Florence, Italy

    Michaela Servi, Francesco Buonamici, Rocco Furferi, Lapo Governi, Francesca Uccheddu & Yary Volpe

  2. Children’s Hospital A. Meyer of Florence, Viale Gaetano Pieraccini, 24, 50139, Florence, Italy

    Stella Leng, Flavio Facchini, Marco Ghionzoli & Antonio Messineo

Authors
  1. Michaela Servi
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Francesco Buonamici
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Rocco Furferi
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Lapo Governi
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Francesca Uccheddu
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Yary Volpe
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Stella Leng
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Flavio Facchini
    View author publications

    You can also search for this author inPubMed Google Scholar

  9. Marco Ghionzoli
    View author publications

    You can also search for this author inPubMed Google Scholar

  10. Antonio Messineo
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Michaela Servi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Servi, M., Buonamici, F., Furferi, R. et al. Pectus Carinatum: a non-invasive and objective measurement of severity. Med Biol Eng Comput 57, 1727–1735 (2019). https://doi.org/10.1007/s11517-019-01993-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-019-01993-0

Keywords