TY - JOUR
T1 - Conventional CT versus Dedicated CT Angiography in DIEP Flap Planning: A Feasibility Study
AU - D’Angelo, Anna
AU - Cina, Alessandro
AU - Macri, Giulia
AU - Belli, Paolo
AU - Mercogliano, Sara
AU - Barbieri, Pierluigi
AU - Grippo, Cristina
AU - Franceschini, Gianluca
AU - D’Archi, Sabatino
AU - Mason, Elena Jane
AU - Visconti, Giuseppe
AU - Barone Adesi, Liliana
AU - Salgarello, Marzia
AU - Manfredi, Riccardo
PY - 2021
Y1 - 2021
N2 - The deep inferior epigastric perforator (DIEP) flap is used with increasing frequency in post-mastectomy breast reconstruction. Preoperative mapping with CT angiography (CTa) is crucial in reducing surgical complications and optimizing surgical techniques. Our study’s goal was to investigate the accuracy of conventional CT (cCT), performed during disease staging, compared to CTa in preoperative DIEP flap planning. In this retrospective, single-center study, we enrolled patients scheduled for mastectomy and DIEP flap breast reconstruction, subjected to cCT within 24 months after CTa. We included 35 patients in the study. cCT accuracy was 95% (CI 0.80–0.98) in assessing the three largest perforators, 100% (CI 0.89–100) in assessing the dominant perforator, 93% (CI 0.71–0.94) in assessing the perforator intramuscular course, and 90.6% (CI 0.79–0.98) in assessing superficial venous communications. Superficial inferior epigastric artery (SIEA) caliber was recognized in 90% of cases (CI 0.84–0.99), with an excellent assessment of superficial inferior epigastric vein (SIEV) integrity (96% of cases, CI 0.84–0.99), and a lower accuracy in the evaluation of deep inferior epigastric artery (DIEA) branching type (85% of cases, CI 0.69–0.93). The mean X-ray dose spared would have been 788 ± 255 mGy/cm. Our study shows that cCT is as accurate as CTa in DIEP flap surgery planning.
AB - The deep inferior epigastric perforator (DIEP) flap is used with increasing frequency in post-mastectomy breast reconstruction. Preoperative mapping with CT angiography (CTa) is crucial in reducing surgical complications and optimizing surgical techniques. Our study’s goal was to investigate the accuracy of conventional CT (cCT), performed during disease staging, compared to CTa in preoperative DIEP flap planning. In this retrospective, single-center study, we enrolled patients scheduled for mastectomy and DIEP flap breast reconstruction, subjected to cCT within 24 months after CTa. We included 35 patients in the study. cCT accuracy was 95% (CI 0.80–0.98) in assessing the three largest perforators, 100% (CI 0.89–100) in assessing the dominant perforator, 93% (CI 0.71–0.94) in assessing the perforator intramuscular course, and 90.6% (CI 0.79–0.98) in assessing superficial venous communications. Superficial inferior epigastric artery (SIEA) caliber was recognized in 90% of cases (CI 0.84–0.99), with an excellent assessment of superficial inferior epigastric vein (SIEV) integrity (96% of cases, CI 0.84–0.99), and a lower accuracy in the evaluation of deep inferior epigastric artery (DIEA) branching type (85% of cases, CI 0.69–0.93). The mean X-ray dose spared would have been 788 ± 255 mGy/cm. Our study shows that cCT is as accurate as CTa in DIEP flap surgery planning.
KW - DIEP flap planning
KW - breast cancer
KW - conventional CT and CT angiography
KW - DIEP flap planning
KW - breast cancer
KW - conventional CT and CT angiography
UR - http://hdl.handle.net/10807/178226
U2 - 10.3390/jpm11040277
DO - 10.3390/jpm11040277
M3 - Article
SN - 2075-4426
VL - 11
SP - 277
EP - 277
JO - Journal of Personalized Medicine
JF - Journal of Personalized Medicine
ER -