The evaluation of breast tissues removed during reductive mammaplasty with dual energy X-ray absorptiometry.

PURPOSE: We conducted a case-control study in which patients were evaluated with dual energy X-ray absorptiometry (DEXA) before and after breast reduction surgery, and results were correlated with the histological examination. Our goal was to confirm the DEXA as a precise technique for the measurement of breast composition, in order to propose it for the preoperative evaluation of plastic surgery patients. MATERIALS AND METHODS: We prospectively recruited all women that underwent reduction mammaplasty and excluded patients with contraindications to the operation or those that previously underwent bariatric surgery to reduce their weight. Patients were evaluated with DEXA 1 week before and after surgery. RESULTS: From February to October 2006 we recruited 25 patients. The statistical analysis found a significant reduction of weight, BMI, regional fat free mass and fat mass after the operation. The comparison between DEXA and the histological analysis produced a correlation r=0.989 (r(2)=0.978), with a predictivity of 98% and a percentage of error 8.3% (95% confidence intervals -252.6, 273.7; 95% limits of agreements of Bland and Altman -436.0, 457.1). Similar results were obtained with the analysis of fat. CONCLUSIONS: Our study demonstrated that conventional segmental DEXA is a very precise technique to measure the amount of tissue removed in breast reductions and could open future application in the preoperative assessment of patients undergoing such operations.

Is digital image plethysmographic (DIP) acquisition a valid new tool for preoperative body composition assessment? A validation by dual-energy X-ray absorptiometry.

BACKGROUND: The increasing incidence of obesity and the wider acceptance of laparoscopic surgery, have lead to a 10-fold increase in bariatric operations in the last 10 years. Widely used indices of obesity (weight and body mass index - BMI) cannot adequately distinguish between fat mass (FM), represented by the sum of kilograms (kg) of lipid, and fat-free mass (FFM), inclusive of lean (kg of proteins), bone (kg of minerals), glycogen, and total body water (TBW), which are important parameters for clinical and physiological studies. METHODS: Anthropometric variables were measured in 19 Caucasian Italian individuals according to standard methods. Body weight (kg) and height (m) were measured, and BMI was calculated as kg/m(2). Body composition was evaluated, with a mean BMI of 25.95+/-5.04 kg/m(2), by dual X-ray absorptiometry (DXA) and by digital image plethysmographic (DIP) acquisition with a digital camera. The clear-colored body of the subjects was automatically converted into a front and lateral red-shaped figure, and then through algorithms the 2 pictures were transformed into a nominal volume; body weight was then divided by the estimated volume, so that the body density could be obtained. DXA was used as a comparison to assess fat mass and fat-free mass. Radiation exposure was <0.6 mSv. RESULTS: Significant positive correlation (R= 0.971, P<0.001) was found between data of body composition obtained by DXA and DIP. CONCLUSIONS: Body volume assessed using DIP or DXA did not differ. According to this validation study, DIP represents a new promising tool for clinical applications.