Body surface area determined by whole‐body CT scanning: need for new formulae?

Abstract

Calculation of the estimated body surface area (BSA) by body height and weight has been a challenge in the past centuries due to lack of a well-documented gold standard. More recently, available techniques such as 3D laser surface scanning and CT scanning may be expected to quantify the BSA in an easier and more accurate way. This study provides the first comparison between BSA obtained from post-mortem whole-body CT scans and BSA calculated by nine predictive formulae. The sample consisted of 54 male cadavers ranging from 20 to 87 years old. 3D reconstructions were generated from CT scans using Mimics software, and BSA values were automatically extracted from the program. They were compared with nine predictive equations from the literature. Remarkably, close correlations (r > 0·90) were found between BSA values from CT scans and those from the predictive formulae. A mean BSA of the 54 cadavers of 1·84-1·87 m was calculated by all formulae except one, SD values varying between 0·171 and 0·223 m . T-tests revealed significant differences between mean BSA values calculated with CT and three of the formulae. Regression analyses showed intercepts >(0;0) and slopes <1·0 using all predictive equations, with the CT scan determination as gold standard. It is concluded that DuBois and DuBois' equation can be safely used in normal-weight male subjects with high accuracy, but it seems likely that BSA is underestimated in underweight subjects and overestimated in overweight individuals. Creation of new formulae specific for overweight subjects and children may be needed.

Body composition estimation from selected slices: equations computed from a new semi-automatic thresholding method developed on whole-body CT scans

“…We analyzed part of a dataset of whole-body CT scans performed on cadavers at the University of Copenhagen, Department of Forensic Medicine, Unit of Forensic Anthropology in Copenhagen, Denmark (Villa et al, 2017). No formal ethical consent is needed from Danish ethical committees to work with CT images of dead humans.…”

“…Bodies were scanned within three days after death and exhibited very limited or none sign of decomposition The bodies were stored in a cold environment of 4–5 °C prior to being scanned. The sample was randomly constituted; it corresponds to people who died when the data was collected (Villa et al, 2017). The sample consisted of 36 males and five females with a range of weight that encompasses a large diversity (Table 1); five individuals are considered underweight, 20 have a weight within the physiological range, 15 are considered overweight and one is considered obese.…”

Diaphysator: An online application for the exhaustive cartography and user‐friendly statistical analysis of long bone diaphyses

“…To test the efficiency of both the Extractor and Diaphysator, we used a sample of whole‐body CT scans performed on cadavers at the University of Copenhagen, Department of Forensic Medicine, Unit of Forensic Anthropology in Copenhagen, Denmark (Lacoste Jeanson, Dupej, et al, ; Lacoste Jeanson, Santos, et al, ; Villa et al, ). The bodies have not been positioned in a standardized fashion prior to scanning.…”

“…The sample consists of 36 males and 42 females. Full descriptive data of the sample can be found elsewhere (Lacoste Jeanson, Dupej, et al, ; Lacoste Jeanson, Santos, et al, ; Villa et al, ). The full data, along with those of the tibial diaphysis, are publicly available on Zenodo (Lacoste Jeanson, ) or by clicking the “Help” button in the Diaphysator user interface.…”

High‐Resolution Three‐Dimensional Photonic Scan‐Derived Equations Improve Body Surface Area Prediction in Diverse Populations

“…Despite being developed more than 100 years ago and based on an extremely small sample, the DuBois and DuBois equation continues to be the most commonly used prediction equation in clinical practice. The DuBois and DuBois equation has been shown to underestimate BSA for low BMI and to both underestimate and overestimate BSA for high BMI. Under‐ or overestimation may lead to inadequate treatment .…”