Three-dimensional imaging provides reliable size measurement of skin lesions associated with vascular anomalies: A comparison with two-dimensional photography

Three-dimensional (3D) imaging techniques enable accurate quantitative size measurement, and have been used to evaluate treatment effects on skin lesions such as ulcers, burns, and skin laxity. This study aimed to establish and validate a 3D imaging–based method to evaluate the surface area, area, and volume of cutaneous lesions associated with vascular anomalies (VA). We compared measurements obtained from two-dimensional (2D) photographs traced by three dermatologists with those obtained from 3D images traced by three company operators, and assessed inter- and intra-rater reliability. The procedure in the present study involves tracing lesion contours using photographs of VA captured by a 3D camera, followed by 3D processing of the images to measure lesion area, surface area, and volume. All patients provided written informed consent, and the study protocol was approved by the institutional review boards. Both 2D and 3D methods demonstrated high inter- and intra-rater reliability; however, better reliability was observed in the measurements obtained by company operators using 3D imaging. The findings indicate that 3D surface imaging provides more consistent and objective evaluation of lesion size than 2D photography and support the potential application of this method in clinical practice and clinical trials for VA. Accurate quantitative measurement of lesion size as an endpoint may facilitate the development of new treatment options for patients with VA.