Reliability and Agreement of Automated Head Measurements From 3-Dimensional Photogrammetry in Young Children

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This study aimed to assess the reliability and agreement of automated head measurements using 3-dimensional (3D) photogrammetry in young children. Specifically, the study evaluated the agreement between manual and automated occipitofrontal circumference (OFC) measurements (n = 264) obtained from 3D images of 188 patients diagnosed with sagittal synostosis using a novel automated method proposed in this study. In addition, the study aimed to determine the interrater and intrarater reliability of the automatically extracted OFC, cephalic index, and volume. The results of the study showed that the automated OFC measurements had an excellent agreement with manual measurements, with a very strong regression score (R2 = 0.969) and a small mean difference of -0.1 cm (-0.2%). The limits of agreement ranged from -0.93 to 0.74 cm, falling within the reported limits of agreement for manual OFC measurements. High interrater and intrarater reliability of OFC, cephalic index, and volume measurements were also demonstrated. The proposed method for automated OFC measurements was found to be a reliable alternative to manual measurements, which may be particularly beneficial in young children who undergo 3D imaging in craniofacial centers as part of their treatment protocol and in research settings that require a reproducible and transparent pipeline for anthropometric measurements. The method has been incorporated into CraniumPy, an open-source tool for 3D image visualization, registration, and optimization, which is publicly available on GitHub (

Original languageEnglish
Pages (from-to)1629-1634
Number of pages6
JournalThe Journal of craniofacial surgery
Issue number6
Early online date12 Jun 2023
Publication statusPublished - 1 Sept 2023

Bibliographical note

Funding Information:
This work was in part supported by the Mrace Erasmus MC Grant 2018 and the Sophia Fonds Grant 2022.

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.


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