Abstract
3D models are crucial in predicting aesthetic outcomes in breast reconstruction, supporting personalized surgical planning, and improving patient communication. In response to this necessity, this is the first application of Radiance Fields to 3D breast reconstruction. Building on this, the work compares six SoTA 3D reconstruction models. It introduces a novel variant tailored to medical contexts: Depth-Splatfacto, designed to improve denoising and geometric consistency through pseudo-depth supervision. Additionally, we extended model training to grayscale, which enhances robustness under grayscale-only input constraints. Experiments on a breast cancer patient dataset demonstrate that Splatfacto consistently outperforms others, delivering the highest reconstruction quality (PSNR 27.11, SSIM 0.942) and the fastest training times (×1.3 faster at 200k iterations). At the same time, the depth-enhanced variant offers an efficient and stable alternative with minimal fidelity loss. The grayscale train improves speed by ×1.6 with a PSNR drop of 0.70. Depth-Splatfacto further improves robustness, reducing PSNR variance by 10% and making images less blurry across test cases. These results establish a foundation for future clinical applications, supporting personalized surgical planning and improved patient-doctor communication. © 2025 Elsevier B.V., All rights reserved.