The accuracy of different modalities of perforator mapping for unilateral DIEP flap breast reconstruction: A systematic review and meta-analysis

Kiely, John; Kumar, Mayank; Wade, Ryckie G.

doi:10.1016/j.bjps.2020.12.005

Cited by 24 publications

(20 citation statements)

References 64 publications

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“…Under different CT reconstruction algorithms, doctors' diagnoses vary widely. Thus, it is essential to observe the impact of images under different CT reconstruction algorithms on benign and malignant pulmonary nodule models and doctors' diagnoses [ 20 – 22 ]. The image in mediastinal reconstruction is smooth, the image in bone window reconstruction is sharp, and the image in lung window reconstruction is between the two.…”

Section: Discussionmentioning

confidence: 99%

Classification and Segmentation Algorithm in Benign and Malignant Pulmonary Nodules under Different CT Reconstruction

Long

2022

Computational and Mathematical Methods in Medicine

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Background and Objective. Effective segmentation of pulmonary nodules can effectively assist in the diagnosis of benign and malignant pulmonary nodules. We aim to explore the effectiveness of classification and segmentation algorithms in diagnosing benign and malignant pulmonary nodules under different CT reconstructions. Methods. The imaging data of 55 patients with chest CT plain scan in the Xuancheng People’s Hospital were collected retrospectively. The data of each patient included lung window reconstruction, mediastinum reconstruction, and bone window reconstruction. The depth neural network and 3D convolution neural network were used to construct the model and train the classification and segmentation algorithm. The pathological results were the gold standard for benign and malignant pulmonary nodules. The classification and segmentation algorithms under three CT reconstruction algorithms were compared and analyzed by analysis of variance. Results. Under the three CT reconstruction algorithms, the classification accuracy of pulmonary nodule density types was 98.2%, 96.4%, and 94.5%, respectively. The Dice coefficients of all nodule segmentation were 80.32 % ± 5.91 % , 79.83 % ± 6.12 % , and 80.17 % ± 5.89 % , respectively. The diagnostic accuracy between benign and malignant pulmonary nodules under different reconstruction algorithms was 98.2%, 96.4%, and 94.5%, respectively. There was no significant difference in the classification accuracy, Dice coefficients, and diagnostic accuracy of pulmonary nodules under three different reconstruction algorithms (all P > 0.05 ). Conclusion. The depth neural network algorithm combined with 3D convolution neural network has a good efficiency in identifying benign and malignant pulmonary nodules under different CT reconstruction classification and segmentation algorithms.

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Section: Discussionmentioning

confidence: 99%

Classification and Segmentation Algorithm in Benign and Malignant Pulmonary Nodules under Different CT Reconstruction

Long

2022

Computational and Mathematical Methods in Medicine

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“…22 However, Kiely et al found that perforator caliber discrepancy was greater for CTA (0.22–5.4mm) than CDU (0.11mm). 21 Cina et al suggested that CDU is better at measuring the diameter corresponding to only the artery as opposed to the sum of the vein and artery. 17…”

Section: Comparison Of Us With Other Imaging Modalitiesmentioning

confidence: 99%

Current Applications of Ultrasound Imaging in the Preoperative Planning of DIEP Flaps

Perez-Iglesias

Laikhter

Kang

et al. 2022

J Reconstr Microsurg

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Background The deep inferior epigastric artery perforator (DIEP) flap has become the gold standard for autologous breast reconstruction at many institutions. Although the deep inferior epigastric artery displays significant anatomic variability in its intramuscular course, branching pattern and location of perforating vessels, the ability to preoperatively visualize and map relevant vascular anatomy has increased the efficiency, safety and reliability of the DIEP flap. While computed tomography angiography (CTA) is often cited as the preoperative imaging modality of choice for perforator flaps, more recent advances in ultrasound technology have made it an increasingly attractive alternative. Methods An extensive literature review was performed to identify the most common applications of ultrasound technology in the preoperative planning of DIEP flaps. Results This review demonstrated that multiple potential uses for ultrasound technology in DIEP flap reconstruction including preoperative perforator mapping, evaluation of the superficial inferior epigastric system and as a potential adjunct in flap delay procedures. Available studies suggest that ultrasound compares favorably to other widely-used imaging modalities for these indications. Conclusion This article presents an in-depth review of the current applications of ultrasound in the preoperative planning of DIEP flaps and explores some potential areas for future investigation.

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“…Depending on the respective institution, several perforator detection methods are in use, with CT-or MR-angiography (CT-A, MR-A) being the gold standard that could be complemented with new techniques [5,[8][9][10][11]. Critics of these techniques describe several limitations thereof, e.g., radiation exposure (CT-A), need for an intravenous contrast agent, or imprecise transferability from a digital image rendered on a screen to the actual patient [12].…”

Section: Introductionmentioning

confidence: 99%

Thermal, Hyperspectral, and Laser Doppler Imaging: Non-Invasive Tools for Detection of The Deep Inferior Epigastric Artery Perforators—A Prospective Comparison Study

Nischwitz

Luze

Schellnegger

et al. 2021

JPM

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Perforator flaps have become one of the leading procedures in microsurgical tissue transfer. Individual defects require a tailored approach to guarantee the most effective treatment. A thorough understanding of the individual vascular anatomy and the location of prominent perforators is of utmost importance and usually requires invasive angiography or at least acoustic Doppler exploration. In this study, we aimed at evaluating different non-invasive imaging modalities as possible alternatives for perforator location detection. After a cooling phase, we performed thermal, hyperspectral and Laser Doppler imaging and visually evaluated a possible detection of the perforator for a period of five minutes with an image taken every minute. We identified the most prominent perforator of the deep inferior epigastric artery by handheld acoustic Doppler in 18 patients. The detected perforator locations were then correlated. Eighteen participants were assessed with six images each per imaging method. We could show a positive match for 94.44%, 38.89%, and 0% of patients and 92.59%, 25.93%, and 0% of images for the methods respectively compared to the handheld acoustic Doppler. Sex, age, abdominal girth, and BMI showed no correlation with a possible visual detection of the perforator in the images. Therefore, thermal imaging can yield valuable supporting data in the individualized procedure planning. Future larger cohort studies are required to better assess the full potential of modern handheld thermal imaging devices.

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The accuracy of different modalities of perforator mapping for unilateral DIEP flap breast reconstruction: A systematic review and meta-analysis

Cited by 24 publications

References 64 publications

Classification and Segmentation Algorithm in Benign and Malignant Pulmonary Nodules under Different CT Reconstruction

Classification and Segmentation Algorithm in Benign and Malignant Pulmonary Nodules under Different CT Reconstruction

Current Applications of Ultrasound Imaging in the Preoperative Planning of DIEP Flaps

Thermal, Hyperspectral, and Laser Doppler Imaging: Non-Invasive Tools for Detection of The Deep Inferior Epigastric Artery Perforators—A Prospective Comparison Study

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