BS18 Variation in thoracic surface anatomy according to age, ethnicity and historical factors

Introduction A precise understanding of surface anatomy is required to successfully and safely perform percutaneous procedures. The majority of thoracic surface anatomy is based off evidence gathered many years ago from young male cadavers. Today, the majority of procedures are carried out on an ageing population of different genders and ethnicities. The aim of this literature review is to evaluate the extent to which age and ethnicity influence the location of surface anatomical landmarks. If these factors are found to influence surface anatomy it may change how we perform certain procedures in a diverse modern population. Methods A literature search was conducted for studies published between the years 2000 and 2020. These articles must include thoracic surface anatomy landmarks in healthy populations across a broad age range. All studies were published in the English language and used cross-sectional imaging to identify landmarks. Results Our review identified that the majority of papers did show a variation in surface anatomy according to age and ethnicity. There is a lack of research published on subjects in a paediatric population. However, from the limited data, there were discrepancies between certain anatomical landmarks depending on the age of the patient. Very few ethnicities have been researched with regards to surface anatomy. After comparing these ethnicities in a table showing different landmarks, it concluded that there are inconsistencies between surface anatomy in different ethnicities. A comparative analysis of these studies highlights the need for further research to explore a broader range of ethnicities and their potential anatomical differences. Conclusion Our findings show that surface anatomy is influenced by age, gender and ethnicity. Whether these influences are clinically significant is debatable but there is an increasing demand on health systems to take a more inclusive approach towards the increasing diversity of patients. The majority of these studies used data gathered from visual inspection of cross-sectional imaging by a radiologist. To improve precision, modern 3D imaging can be used, such as the Materialise Mimics® software. This allows detailed 3D thorax models to be created based on an individual's surface anatomy. Therefore, allowing us to compare these landmarks quantitatively.