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Check the Record: Remote CT Scans for Breast Flap Perforator Mapping
Amanda R Sergesketter1, Bryan J Pyfer1, Brett T Phillips1
1Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, North Carolina.
Journal of Reconstructive Microsurgery
|April 2, 2018
Summary
Using pre-existing CT scans for perforator mapping in autologous breast reconstruction is a cost-effective alternative. This method reduces radiation exposure and healthcare costs, improving patient outcomes.
Area of Science:
- Plastic Surgery
- Radiology
- Oncology
Background:
- Perforator mapping via computed tomography angiography (CTA) aids autologous breast reconstruction but incurs high costs.
- Evaluating pre-existing CT scans for perforator identification aims to reduce morbidity and operative time.
Purpose of the Study:
- To assess the viability of using pre-existing CT scans for dominant perforator identification in autologous breast reconstruction.
- To determine the financial savings and radiation reduction benefits of utilizing prior CT scans.
Main Methods:
- Retrospective review of female patients undergoing mastectomy with abdominal free flap breast reconstruction (2006-2016).
- Analysis of pre-existing CT scans of the abdomen/pelvis for utility in preoperative planning.
- Assessment of financial and radiation exposure savings.
Main Results:
- 44.9% of patients had available pre-existing CT scans, with 92.6% showing a dominant perforator.
- Positron emission tomography (PET)/CT scans identified more dominant perforators than CT scans with or without intravenous contrast.
- Utilizing remote CT scans projected a radiation reduction of 13.2 mGy per patient and annual US healthcare savings of $28,459,638.
Conclusions:
- Pre-existing CT scans are a practical and economical option for perforator mapping in abdominal free flap breast reconstruction.
- This approach offers significant cost savings and radiation exposure reduction for patients.
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