Use of 3D Stereophotogrammetry helps to detect disease progression in craniofacial morphea: JAMA

In the cohort study of 27 patients with craniofacial morphea, participants underwent clinical and 3D stereophotogrammetry assessments at intervals of t 2- to 12 months. The researchers showed that over 48 months, 10 patients demonstrated CM's clinical progression, which was corroborated by 3D stereophotogrammetry assessment by a non-expert and expert with substantial interrater reliability.

Craniofacial morphea is an autoimmune disorder with characteristics of inflammation and subsequent atrophy of the skin and underlying soft tissue. It is challenging to objectively determine disease progression in CM due to the lack of clinical findings of disease activity. Therefore, Katharina S. Shaw, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, and colleagues aimed to evaluate the utility of 3-dimensional (3D) stereophotogrammetry in detecting disease progression in CM over time.

The study included 27 pediatric and adult patients with CM from two hospitals in Boston consecutively enrolled from 2019 to 2023. The researchers conducted a review of 3D stereophotogrammetry images and data analysis from March 1 to April 1, 2023.

At 2- to 12-month intervals, clinical and 3D stereophotogrammetry assessments were done, depending on the clinical context. The 3D stereophotogrammetry images were then qualitatively rated as showing no progression or definitive progression by a nonexpert (board-certified dermatologist) and an expert (board-certified plastic craniofacial surgeon) in 3D stereophotogrammetry. For interrater reliability, κ coefficients were calculated.

The study led to the following findings:

• Of 27 patients with CM (19 females; median age, 14 years) and 3D stereophotogrammetry images obtained from a minimum of 2-time points (median, 4 images) spaced a median of 3 months apart, 10 experienced progression of their disease based on clinical assessments performed during the study period.
• In all cases in which clinical progression was favoured, blinded qualitative assessment of 3D stereophotogrammetry images also favoured progression with substantial interrater reliability (κ = 0.80).
• A review of 3D stereophotogrammetry detected occult progression of asymmetry not noted on clinical examination in 3 additional patients.

The researchers showed that the blinded assessment of sequential 3D stereophotogrammetry images in CM patients not only corroborated clinical assessment of disease progression but also detected occult progression of facial asymmetry not appreciable on clinical examination alone.

"Therefore, 3D stereophotogrammetry may serve as a useful adjunct to clinical examination of patients with craniofacial morphea over time," they wrote. "To validate 3D stereophotogrammetry as an outcome measure in CM, future investigations are warranted."

Reference:

Shaw KS, Nguyen TT, Rajeh A, et al. Use of 3-Dimensional Stereophotogrammetry to Detect Disease Progression in Craniofacial Morphea. JAMA Dermatol. Published online October 11, 2023. doi:10.1001/jamadermatol.2023.3649