International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences, Vol XXXV, Part B5. Istanbul 2004 
5). Whether the photogrammetric systems will replace those 
methods in the future for clinical measurement of body shape 
will depend on clear advantages that can be demonstrated by 
using photogrammetry. It will not be sufficient to argue that 
rigorous methods of camera calibration and image processing 
have been used, and therefore the technique is more sound 
theoretically. In this respect the method will have to be 
transparent to the operator, be reliable under a variety of 
conditions, be fast and of sufficient accuracy, and as well, 
provide the necessary parameters, either those with which 
surgeons are familiar, or new parameters that can be proved to 
be more appropriate, to enable them to make an appropriate 
diagnosis and decisions about treatment. 
According to (Heuvel, 2002): “Although medical 
photogrammetry can look back on a history of almost a century, 
but photogrammetry never gained solid ground in medicine. 
This is also reflected on the reports of the chairs of the ISPRS 
working groups on this topic. In 1976, a working group of 
Commission V, named *Biostereometrics", was established. In 
1988, *Medical Imaging" was added to the name, and the 
current name of ISPRS working group V/3 is Medical Image 
Analysis and Human Motion". Although the term “Medical 
Imaging” has existed in the Terms of Reference of the Working 
Group ever since, the contribution of photogrammetrists to this 
filed has been limited. However, there is definitely a potential 
for the application of photogrammetric knowledge in the field 
of medical imaging. In 1990, the editorial of the theme issue of 
ISPRS Journal of Photogrammetry & Remote Sensing ended 
with “For those, who are not scared away by the transition form 
pixels to voxels, medical imaging will represents itself as a truly 
interesting discipline and a scientifically very rewarding area, 
which is of great importance to the progress and well-being of 
man-kind". Maybe photogrammetrists did not find the way to 
the voxels as they were occupied in other application fields. 
Nonetheless, the societal relevance of medical applications of 
photogrammetry is obvious, and therefore, anybody with the 
knowledge necessary to bring this field forward should not 
hesitate to do so". The possible advantage of digital 
photogrammetric methods are the superior accuracies that can 
be achieved with precise photogrammetric measuring 
techniques, if such accuracies ! are indeed relevant for 
medicine, potentially superior speed of processing, more robust 
algorithms using image matching and therefore greater 
reliability of the computations, and the relatively simple 
configuration of the photogrammetric systems, which can lead 
to cheaper implementation of the technique. It is the method of 
analyzing and presenting the data that finally determines its 
value to the clinician, and whether all three stages of 
measurement, analysis and presentation can be completed in a 
few minutes. The measurement tasks are the photogrammetrists’ 
business, but of particular importance are the methods of 
analysis and presentation of data. Appropriate procedures have 
to developed to ensure that surgeons are able to use the 
information derived from the measurements. It is therefore a 
matter of adding value and facility to the data derived by the 
measurements (Trinder, 1994). Despite its appeal, the 
implementation of photogrammetry in medicine is not always 
straightforward. Only a few fully developed systems are 
available commercially, mainly for dynamics analysis and back 
shape measurement, and it is often necessary to develop a 
special system for each application. This a matter of applying 
photogrammetric techniques to medical situations with some 
adaptation. It entails making suitable equipment and processing 
software to suit the special needs of the application. Multiple 
cameras must be obtained, control and calibration arranged and 
access to a data reduction system organized. Potential 
difficulties, such as the requirement to obtain imagery with 
good contrast and texture, also need to be resolved. 
9 
Furthermore, the photogrammetrist will need to feel 
comfortable working with human patients and medical 
practitioners in unfamiliar surroundings. If these constraints can 
be overcome, there are few alternatives to photogrammetry in 
many cases of external measurement in medicine and because 
of this photogrammetry has been widely investigated as a tool 
for medical measurement over the past century and a large 
number of papers have been produced. 
However, only a small percentage of the applications have 
resulted in routine usage and there are very few medical 
institutions and related health units that use photogrammetry. 
Thus the real impact of medical photogrammetry on the world 
seems quite limited. Anyhow, it is obvious that close range 
photogrammetry is an effective medical measurement tool, 
which has certain advantages over alternative methods. Some 
practical examples of the medical usage of photogrammetry are 
given below: 
1. Face. Photogrammetric measurement has been used 
to monitor facial shape as it changes over an extended 
period of time and also to investigate changes over 
short periods of time, such as before and after 
cosmetic surgeries. 
Back. Photogrammetry has been used to detect, 
measure and monitor the scoliosis and spinal 
curvature. 
3. Teeth. Photogrammetry has been used to detect the 
occurrence of wear, erosion and abrasion in both 
natural tooth surface and in tooth restoration 
materials, that requires repetitive measurements for 
change detection and monitoring. 
4. Interior parts. Health and medical experts have 
access to a wide range of internal imaging and 
measurement systems. Many have little relevance to 
the photogrammetrist, but a small number of them are 
of interest because of the growing use of digital image 
technologies similar to those used in digital 
photogrammetry. They include X, CT and MRI 
imageries. 
5. Motion Analysis. Photogrammetry has been used in 
the measurement and study of various gait problems, 
arising primarily from deformities or injuries, and 
irregularities in walking patterns that can be relevant 
to other medical conditions, such as diabetes. 
6. Skin. Photogrammetry has been used to study the 
changes of sores, ulcers and melanomas and other 
skin conditions. 
N 
3. WOUND MEASUREMENT 
When a patient is supported in such a manner that a pressure 
sufficient to obstruct blood flow in capillaries results, bedsores 
or pressure ulcers occur. This condition arises at bony 
prominences; by far the most common location is the sacrum. 
An ulcer is a chronic wound of the skin that, at best, takes many 
months to fully heal and causes great distress to the patient. As 
an example, treating ulcers places a large financial burden upon 
the National Health Service in the United Kingdom, estimated 
to be in excess of £300M annually and is predicted to rise to 
£500 million per annum. (Plassmann, 1998). Measurement of 
the size of ulcers is a guide to assessing the progress of wound 
healing, and the use of non-invasive measurement techniques 
avoids damaging or infecting the wound or causing pain for the 
patient. With so many treatments to choose from, doctors need 
a precise and objective means of deciding whether a particular 
treatment is effective. 
   
Inter 
  
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