Wide Area Transepithelial Sampling with Computer-Assisted Analysis (WATS3D) Is Cost-Effective in Barrett's Esophagus Screening.

BACKGROUND: Wide area transepithelial sampling with three-dimensional computer-assisted analysis (WATS3D) is an adjunct to the standard random 4-quadrant forceps biopsies (FB, "Seattle protocol") that significantly increases the detection of Barrett's esophagus (BE) and associated neoplasia in patients undergoing screening or surveillance. AIMS: To examine the cost-effectiveness of adding WATS3D to the Seattle protocol in screening patients for BE. METHODS: A decision analytic model was used to compare the effectiveness and cost-effectiveness of two alternative BE screening strategies in chronic gastroesophageal reflux disease patients: FB with and without WATS3D. The reference case was a 60-year-old white male with gastroesophageal reflux disease (GERD). Effectiveness was measured by the number needed to screen to avert one cancer and one cancer-related death, and quality-adjusted life years (QALYs). Cost was measured in 2019 US$, and the incremental cost-effectiveness ratio (ICER) was measured in $/QALY using thresholds for cost-effectiveness of $100,000/QALY and $150,000/QALY. Cost was measured in 2019 US$. Cost and QALYs were discounted at 3% per year. RESULTS: Between 320 and 337 people would need to be screened with WATS3D in addition to FB to avert one additional cancer, and 328-367 people to avert one cancer-related death. Screening with WATS3D costs an additional $1219 and produced an additional 0.017 QALYs, for an ICER of $71,395/QALY. All one-way sensitivity analyses resulted in ICERs under $84,000/QALY. CONCLUSIONS: Screening for BE in 60-year-old white male GERD patients is more cost-effective when WATS3D is used adjunctively to the Seattle protocol than with the Seattle protocol alone.

Low-Cost, Three-Dimensionally-Printed, Anatomical Models for Optimization of Orbital Wall Reconstruction.

BACKGROUND: Orbital blowout fracture reconstruction often requires an implant, which must be shaped at the time of surgical intervention. This process is time-consuming and requires multiple placement trials, possibly risking complications. Three-dimensional printing technology has enabled health care facilities to generate custom anatomical models to which implants can be molded to precisely match orbital anatomy. The authors present their early experience with these models and their use in optimizing orbital fracture fixation. METHODS: Maxillofacial computed tomographic scans from patients with orbital floor or wall fractures were prospectively obtained and digitally reconstructed. Both injured-side and mirrored unaffected-side models were produced in-house by stereolithography printing technique. Models were used as templates for molding titanium reconstruction plates, and plates were implanted to reconstruct the patients' orbital walls. RESULTS: Nine patients (mean age, 15.5 years) were included. Enophthalmos was present in seven patients preoperatively and resolved in six patients with surgery. All patients had excellent conformation of the implant to the fracture site on postoperative computed tomographic scan. Postoperative fracture-side orbital volumes were significantly less than preoperative, and not significantly different from unfractured-side orbital volumes. Total model preparation time was approximately 10 hours. Materials cost was at most $21. Plate bending time was approximately 60 seconds. CONCLUSIONS: Patient-specific orbital models can speed the shaping of orbital reconstruction implants and potentially improve surgical correction of orbital fractures. Production of these models with consumer-grade technology confers the same advantages as commercial production at a fraction of the cost and time. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

High-speed super-resolution imaging of rotationally symmetric structures using SPEED microscopy and 2D-to-3D transformation.

Various super-resolution imaging techniques have been developed to break the diffraction-limited resolution of light microscopy. However, it still remains challenging to obtain three-dimensional (3D) super-resolution information of structures and dynamic processes in live cells at high speed. We recently developed high-speed single-point edge-excitation sub-diffraction (SPEED) microscopy and its two-dimensional (2D)-to-3D transformation algorithm to provide an effective approach to achieving 3D sub-diffraction-limit information in subcellular structures and organelles that have rotational symmetry. In contrast to most other 3D super-resolution microscopy or 3D particle-tracking microscopy approaches, SPEED microscopy does not depend on complex optical components and can be implemented onto a standard inverted epifluorescence microscope. SPEED microscopy is specifically designed to obtain 2D spatial locations of individual immobile or moving fluorescent molecules inside sub-micrometer biological channels or cavities at high spatiotemporal resolution. After data collection, post-localization 2D-to-3D transformation is applied to obtain 3D super-resolution structural and dynamic information. The complete protocol, including cell culture and sample preparation (6-7 d), SPEED imaging (4-5 h), data analysis and validation through simulation (5-13 h), takes ~9 d to complete.

Three-Dimensional Facial Scanning at the Fingertips of Patients and Surgeons: Accuracy and Precision Testing of iPhone X Three-Dimensional Scanner.

BACKGROUND: The iPhone X (Apple, Inc., Cupertino, Calif.) is the first smartphone to be released with a high-fidelity three-dimensional scanner. At present, half of all U.S. smartphone users use an iPhone. Recent data suggest that the majority of these 230 million individuals will upgrade to the iPhone X within 2 years. This represents a profound expansion in access to three-dimensional scanning technology, not only for plastic surgeons but for their patients as well. The purpose of this study was to compare the iPhone X scanner against a popular, portable three-dimensional camera used in plastic surgery (Canfield Vectra H1; Canfield Scientific, Inc., Parsippany, N.J.). METHODS: Sixteen human subjects underwent three-dimensional facial capture with the iPhone X and Canfield Vectra H1. Results were compared using color map analysis and surface distances between key anatomical landmarks. To assess repeatability and precision of the iPhone X three-dimensional scanner, six facial scans of a single participant were obtained and compared using color map analysis. In addition, three-dimensionally-printed facial masks (n = 3) were captured with each device and compared. RESULTS: For the experiments, average root mean square was 0.44 mm following color map analysis and 0.46 mm for surface distance between anatomical landmarks. For repeatability and precision testing, average root mean square difference following color map analysis was 0.35 mm. For the three-dimensionally-printed facial mask comparison, average root mean square difference was 0.28 mm. CONCLUSIONS: The iPhone X offers three-dimensional scanning that is accurate and precise to within 0.5 mm when compared to a commonly used, validated, and expensive three-dimensional camera. This represents a significant reduction in the barrier to access to three-dimensional scanning technology for both patients and surgeons.

Accelerating Brain 3D T1-Weighted Turbo Field Echo MRI Using Compressed Sensing-Sensitivity Encoding (CS-SENSE).

PURPOSE: To evaluate the clinical application of the accelerated 3D T1-weighted turbo field echo (T1W-TFE) using the compressed sensing-sensitivity encoding (CS-SENSE) and identify the appropriate acceleration factor. METHODS: 33 healthy controls (HC), 10 multiple sclerosis (MS) and 10 Alzheimer's disease (AD) patients were prospectively recruited. A conventional 3D T1W-TFE sequence and accelerated sequences with CS-SENSE factors of 3, 4.5, 6 and with SENSE factors of 3, 4.5 were acquired for all participants on a 3.0T MR system. The visual evaluation was independently assessed by two experienced radiologists. Quantitative image quality metrics and intraclass correlation coefficients (ICCs) between the conventional and the accelerated sequences were performed at the voxel level. Group comparisons were performed between HC and AD or MS patients. RESULTS: There were no significant differences in the visual image quality metrics between conventional sequence and CS-SENSE factor of 3. The sequences with CS-SENSE factor of 6 and SENSE factors of 3, 4.5 showed significantly decreased overall image quality. The ICC values based on the voxel level of each accelerated scan and conventional scan were high (>0.9, 85.2%). For different accelerated sequences, AD and MS patients showed consistent results with the conventional sequence in gray matter atrophy when compared to HC. CONCLUSIONS: CS-SENSE factor of 3 is the appropriate parameter to accelerate the 3D T1W-TFE (65% time reduction) with preserved visual image quality. The voxel-based analysis demonstrated high ICCs for brain volume measurements in the majority of brain regions, implying the feasibility of the accelerated technique.

A rapid and cost-effective pipeline for digitization of museum specimens with 3D photogrammetry.

Natural history collections are yielding more information as digitization brings specimen data to researchers, connects specimens across museums, and as new technologies allow for more large-scale data collection. Therefore, a key goal in specimen digitization is developing methods that both increase access and allow for the highest yield of phenomic data. 3D digitization is increasingly popular because it has the potential to meet both aspects of that key goal. However, current methods overlook or do not prioritize some of the most sought-after phenotypic traits, those involving the external appearance of specimens, especially color. Here, we introduce an efficient and cost-effective pipeline for 3D photogrammetry to capture the external appearance of natural history specimens and other museum objects. 3D photogrammetry aligns and compares sets of dozens, hundreds, or even thousands of photos to create 3D models. The hardware set-up requires little physical space and around $3,000 in initial investment, while the software pipeline requires $1,400/year for proprietary software subscriptions (with open-source alternatives). The creation of each 3D model takes 1-2 hours/specimen and much of the software pipeline is automated with minimal supervision required, including the onerous step of mesh processing. We showcase the method by creating 3D models for most of the type specimens in the Moore Laboratory of Zoology bird collection and show that digital bill measurements are comparable to hand-taken measurements. Color data, while not included as part of this pipeline, is easily extractable from the models and one of the most promising areas of data collection. Future advances can adapt the method for ultraviolet reflectance capture and increased efficiency and model quality. Combined with genomic data, phenomic data from 3D models including photogrammetry will open new doors to understanding organismal evolution.

Usefulness of three-dimensional printing of superior mesenteric vessels in right hemicolon cancer surgery.

The anatomy of the superior mesenteric vessels is complex, yet important, for right-sided colorectal surgery. The usefulness of three-dimensional (3D) printing of these vessels in right hemicolon cancer surgery has rarely been reported. In this prospective clinical study, 61 patients who received laparoscopic surgery for right hemicolon cancer were preoperatively randomized into 3 groups: 3D-printing (20 patients), 3D-image (19 patients), and control (22 patients) groups. Surgery duration, bleeding volume, and number of lymph node dissections were designed to be the primary end points, whereas postoperative complications, post-operative flatus recovery time, duration of hospitalization, patient satisfaction, and medical expenses were designed to be secondary end points. To reduce the influence of including different surgeons in the study, the surgical team was divided into 2 groups based on surgical experience. The duration of surgery for the 3D-printing and 3D-image groups was significantly reduced (138.4 ± 19.5 and 154.7 ± 25.9 min vs. 177.6 ± 24.4 min, P = 0.000 and P = 0.006), while the number of lymph node dissections for the these 2 groups was significantly increased (19.1 ± 3.8 and 17.6 ± 3.9 vs. 15.8 ± 3.0, P = 0.001 and P = 0.024) compared to the control group. Meanwhile, the bleeding volume for the 3D-printing group was significantly reduced compared to the control group (75.8 ± 30.4 mL vs. 120.9 ± 39.1 mL, P = 0.000). Moreover, patients in the 3D-printing group reported increased satisfaction in terms of effective communication compared to those in the 3D-image and control groups. Medical expenses decreased by 6.74% after the use of 3D-printing technology. Our results show that 3D-printing technology could reduce the duration of surgery and total bleeding volume and increase the number of lymph node dissections. 3D-printing technology may be more helpful for novice surgeons.Trial registration: Chinese Clinical Trial Registry, ChiCTR1800017161. Registered on 15 July 2018.

Cost-Effective Method for 3-Dimensional Printing Dynamic Multiobject and Patient-Specific Brain Tumor Models: Technical Note.

BACKGROUND: Three-dimensional (3D) printing is a powerful tool for replicating patient-specific anatomic features for education and surgical planning. The advent of "desktop" 3D printing has created a cost-effective and widely available means for institutions with limited resources to implement a 3D-printing workflow into their clinical applications. The ability to physically manipulate the desired components of a "dynamic" 3D-printed model provides an additional dimension of anatomic understanding. There is currently a gap in the literature describing a cost-effective and time-efficient means of creating dynamic brain tumor 3D-printed models. METHODS: Using free, open-access software (3D Slicer) for patient imaging to Standard Tessellation Language file conversion, as well as open access Standard Tessellation Language editing software (Meshmixer), both intraaxial and extraaxial brain tumor models of patient-specific pathology are created. RESULTS: A step-by-step methodology and demonstration of the software manipulation techniques required for creating cost-effective, multidimensional brain tumor models for patient education and surgical planning are exhibited using a detailed written guide, images, and a video display. CONCLUSIONS: In this technical note, we describe in detail the specific functions of free, open-access software and desktop 3D printing techniques to create dynamic and patient-specific brain tumor models for education and surgical planning.

Faster 3D saturation-recovery based myocardial T1 mapping using a reduced number of saturation points and denoising.

PURPOSE: To accelerate the acquisition of free-breathing 3D saturation-recovery-based (SASHA) myocardial T1 mapping by acquiring fewer saturation points in combination with a post-processing 3D denoising technique to maintain high accuracy and precision. METHODS: 3D SASHA T1 mapping acquires nine T1-weighted images along the saturation recovery curve, resulting in long acquisition times. In this work, we propose to accelerate conventional cardiac T1 mapping by reducing the number of saturation points. High T1 accuracy and low standard deviation (as a surrogate for precision) is maintained by applying a 3D denoising technique to the T1-weighted images prior to pixel-wise T1 fitting. The proposed approach was evaluated on a T1 phantom and 20 healthy subjects, by varying the number of T1-weighted images acquired between three and nine, both prospectively and retrospectively. Following the results from the healthy subjects, three patients with suspected cardiovascular disease were acquired using five T1-weighted images. T1 accuracy and precision was determined for all the acquisitions before and after denoising. RESULTS: In the T1 phantom, no statistical difference was found in terms of accuracy and precision for the different number of T1-weighted images before or after denoising (P = 0.99 and P = 0.99 for accuracy, P = 0.64 and P = 0.42 for precision, respectively). In vivo, both prospectively and retrospectively, the precision improved considerably with the number of T1-weighted images employed before denoising (P<0.05) but was independent on the number of T1-weighted images after denoising. CONCLUSION: We demonstrate the feasibility of accelerating 3D SASHA T1 mapping by reducing the number of acquired T1-weighted images in combination with an efficient 3D denoising, without affecting accuracy and precision of T1 values.

Clinical feasibility of ultrafast intracranial vessel imaging with non-Cartesian spiral 3D time-of-flight MR angiography at 1.5T: An intra-individual comparison study.

OBJECTIVES: Non-Cartesian Spiral readout can be implemented in 3D Time-of-flight (TOF) MR angiography (MRA) with short acquisition times. In this intra-individual comparison study we evaluated the clinical feasibility of Spiral TOF MRA in comparison with compressed sensing accelerated TOF MRA at 1.5T for intracranial vessel imaging as it has yet to be determined. MATERIALS AND METHODS: Forty-four consecutive patients with suspected intracranial vascular disease were imaged with two Spiral 3D TOFs (Spiral, 0.82x0.82x1.2 mm3, 01:32 min; Spiral 0.8, 0.8x0.8x0.8 mm3, 02:12 min) and a Compressed SENSE accelerated 3D TOF (CS 3.5, 0.82x0.82x1.2 mm3, 03:06 min) at 1.5T. Two neuroradiologists assessed qualitative (visualization of central and peripheral vessels) and quantitative image quality (Contrast Ratio, CR) and performed lesion and variation assessment for all three TOFs in each patient. After the rating process, the readers were questioned and representative cases were reinspected in a non-blinded fashion. For statistical analysis, the Friedman and Nemenyi post-hoc test, Kendall W tests, repeated measure ANOVA and weighted Cohen's Kappa tests were used. RESULTS: The Spiral and Spiral 0.8 outperformed the CS 3.5 in terms of peripheral image quality (p<0.001) and performed equally well in terms of central image quality (p>0.05). The readers noted slight differences in the appearance of maximum intensity projection images. A good to high degree of interstudy agreement between the three TOFs was observed for lesion and variation assessment (W = 0.638, p<0.001 -W = 1, p<0.001). CR values did not differ significantly between the three TOFs (p = 0.534). Interreader agreement ranged from good (K = 0.638) to excellent (K = 1). CONCLUSIONS: Compared to the CS 3.5, both the Spiral and Spiral 0.8 exhibited comparable or better image quality and comparable diagnostic performance at much shorter acquisition times.

Image-guided pedicle screws using intraoperative cone-beam CT and navigation. A cost-effectiveness study.

Image-guided surgery using intraoperative cone-beam CT and navigation improves screw placement accuracy rates. However, this technology is associated with high acquisition costs. The aim of this study is to evaluate the costs of revision surgery from symptomatic pedicle screw malposition to justify whether the costs of acquiring intraoperative navigation justify the expected benefits. This is a retrospective cost-effectiveness analysis of consecutive patients who had pedicle screw instrumentation using intraoperative cone-beam CT and navigation compared with patients who underwent freehand pedicle screw instrumentation at our institution over 4 years. The costs associated with revision surgery for symptomatic pedicle screw malposition (excess length of stay, intensive care, theatre time, implants and additional outpatient appointments) were calculated. A total of 19 patients had symptomatic screw malpositioning requiring revision surgery. None of these patients had screws inserted under navigation. Revision surgery accounted for an extra 304 bed days and an additional 97 h theatre time. The total extra spent over 4 years was £464,038. When compared to the costs of revision surgery for screw malpositioning, it was cost neutral to acquire and maintain this technology. Intraoperative image-guided surgery reduces reoperation rates for symptomatic screw malposition and is cost-effective in high volume centers with improved patients outcomes. High acquisition and maintenance cost of such technologies is economically justifiable.

Computed tomography for managing periprosthetic femoral fractures. A retrospective analysis.

BACKGROUND: Periprosthetic fractures (PPF) present a common cause for revision surgery after arthroplasty. The choice of performing either an osteosynthesis or revision arthroplasty depends on the orthopedic implant anchored and loosening. Standard diagnostics include x-ray imaging. CT is usually performed to confirm implant loosening in case of ambiguous diagnosis on standard x-ray imaging. This study aimed to examine the role of CT as a diagnostic modality and its implications for treatment planning and outcome. METHODS: Patients treated for PPF from January 2010 to February 2018 were included. X-ray and CT reports were analyzed to assess implant loosening. The planning for surgery and the final surgical treatment were evaluated. In addition, patient characteristics were analyzed and compared between patients with and without additional CT as a preoperative diagnostic procedure. RESULTS: Seventy-five patients were eligible for the study. X-ray imaging was performed in 90.7% of cases. CT was performed in 60% of the cases as part of the preoperative diagnostic. A clear statement on implant stability or loosening could not be made in 69.1% after X-ray imaging and in 84.4% following CT imaging. Revision arthroplasty for loosened femoral prosthesis components was necessary in 40% of cases. No difference could be determined comparing patients with X-ray imaging to those with X-ray and additional CT. In both groups, operative treatment did not deviate from the preoperative planning. DISCUSSION: In two thirds of the conventional radiographic findings, no reliable evaluation of implant loosening was possible in femoral PPFs. Intriguingly, additional CT did not improve the evaluation of implant loosening. Nonetheless, CT scans are often performed if loosening assessment is unclear on regular radiographs. This fact can explain the bias CT results in comparison to regular radiography. However, software-supported CT diagnosis could help to adequately answer the question of loosened implants in PPF in the near future. Since the diagnosis of fracture and their morphology assessment is currently adequately performed using X-rays, CT shall not be considered as the gold standard.

A photometric stereo-based 3D imaging system using computer vision and deep learning for tracking plant growth.

BACKGROUND: Tracking and predicting the growth performance of plants in different environments is critical for predicting the impact of global climate change. Automated approaches for image capture and analysis have allowed for substantial increases in the throughput of quantitative growth trait measurements compared with manual assessments. Recent work has focused on adopting computer vision and machine learning approaches to improve the accuracy of automated plant phenotyping. Here we present PS-Plant, a low-cost and portable 3D plant phenotyping platform based on an imaging technique novel to plant phenotyping called photometric stereo (PS). RESULTS: We calibrated PS-Plant to track the model plant Arabidopsis thaliana throughout the day-night (diel) cycle and investigated growth architecture under a variety of conditions to illustrate the dramatic effect of the environment on plant phenotype. We developed bespoke computer vision algorithms and assessed available deep neural network architectures to automate the segmentation of rosettes and individual leaves, and extract basic and more advanced traits from PS-derived data, including the tracking of 3D plant growth and diel leaf hyponastic movement. Furthermore, we have produced the first PS training data set, which includes 221 manually annotated Arabidopsis rosettes that were used for training and data analysis (1,768 images in total). A full protocol is provided, including all software components and an additional test data set. CONCLUSIONS: PS-Plant is a powerful new phenotyping tool for plant research that provides robust data at high temporal and spatial resolutions. The system is well-suited for small- and large-scale research and will help to accelerate bridging of the phenotype-to-genotype gap.

High-Contrast, Low-Cost, 3-D Visualization of Skin Cancer Using Ultra-High-Resolution Millimeter-Wave Imaging.

The goal of this paper is to develop a new skin imaging modality which addresses the current clinical need for a non-invasive imaging tool that images the skin over its depth with high resolutions while offering large histopathological-like contrasts between malignant and normal tissues. We demonstrate that by taking advantage of the intrinsic millimeter-wave dielectric contrasts between normal and malignant skin tissues, ultra-high-resolution millimeter-wave imaging (MMWI) can achieve 3-D, high-contrast images of the skin. In this paper, an imaging system with a record-wide bandwidth of 98 GHz is developed using the synthetic ultra-wideband millimeter-wave imaging approach, a new ultra-high-resolution imaging technique recently developed by the authors. The 21 non-melanoma skin cancer (NMSC) specimens are imaged and compared with histopathology for evaluation. A programmable measurement platform is designed to automatically scan the tissues across a rectangular aperture plane. Furthermore, a novel frequency-domain imaging algorithm is developed to process the recorded signals and generate an image of the cancerous tissue. The high correlations achieved between MMWI images and histological images allow for rapid and accurate delineation of NMSC tissues. The millimeter-wave reflectivity values are also found to be statistically significant higher for cancerous areas with respect to normal areas. Since MMWI does not require tissue processing or staining, it can be performed promptly, enabling diagnosis of tumors at an early stage as well as simplify the tumor removal surgery to a single-layer excision procedure.

Low-Cost Stereoscopic Recordings of Neurologic Surgery Operative Microscopy for Anatomic Laboratory Training.

OBJECTIVE: Stereoscopic video recordings of operative microscopy during neuroanatomic dissections are an important component of surgical training and research in well-financed medical schools and teaching hospitals. However, the high cost of the latest operative microscopes with integrated video recording equipment can be a limiting factor in their worldwide use. The aim of the present work is to provide a simple low-cost 3-dimensional (3D) stereoscopic operative microscope recording system that can be used even in economically and resource-limited locations. This is achieved by using readily available smartphones, smartphone accessories, and computer software. METHODS: Stereoscopic recording is accomplished by attaching and aligning matched or similar smartphones to the eyepieces of an operative microscope using readily available smartphone mounting connectors. Video recordings from the smartphones are then transferred to a personal computer and processed with a video-editing software to generate stereoscopic movies that are viewed on a smartphone using virtual-reality glasses. RESULTS: The setup time to mount and align the smartphone cameras typically requires 15-30 minutes. Video image quality and 3D depth presentation is more than sufficient for surgical training and research purposes. The implementation cost ranges from $1,315-$7,066, or much less if smartphones and a computer are already available. CONCLUSIONS: The 3D video system demonstrated herein can be implemented on any type of operative microscope, including older units for which commercial stereo recording systems are not available. The system and method presented herein can be readily and affordably implemented in low-budget environments for clinical training and research.

A collaborative, mixed-methods evaluation of a low-cost, handheld 3D imaging system for child anthropometry.

3D imaging for body measurements is regularly used for design of garments and ergonomic products. The development of low-cost 3D scanners provided an opportunity to extend the use of 3D imaging to the health sector. We developed and tested the AutoAnthro System, the first mobile, low-cost, full-body, 3D imaging system designed specifically for child anthropometry. This study evaluated the efficiency, invasiveness, and user experience of the AutoAnthro System. We used a mixed-methods, collaborative approach that included a quantitative time-motion study and qualitative interviews of anthropometrists. For cooperative children, anthropometrists considered the use of 3D imaging an easy, "streamlined experience," but with uncooperative children, anthropometrists reported that capturing a good quality scan was out of their control. The mean time to complete a full set of scans was 68 s (standard deviation [SD] 29), compared with 135 s (SD 22) for a set of manual measurements (stature, head circumference, and arm circumference). We observed that crying was more common during manual measurement, and anthropometrist interviews confirmed that 3D imaging was less stressful for children than manual measurement. In a previous publication, we showed the potential of 3D imaging to produce reliable and accurate measurements. In this study, we found that anthropometrists were not ready to abandon manual equipment for 3D scanners because of difficulty in measuring uncooperative children. Revising the AutoAnthro System to address anthropometrists' concerns on capturing good quality scans of uncooperative children should help to facilitate widespread use of 3D imaging for child anthropometry.