Indocyanine Green Angiography Overpredicts Postoperative Necrosis Compared to Multispectral Reflectance Imaging

Area of Science:

• Plastic Surgery
• Biomedical Imaging
• Tissue Perfusion Analysis

Background:

• Adequate tissue perfusion is critical for successful reconstructive surgery.
• Assessing tissue viability and predicting postoperative necrosis are key challenges.
• Indocyanine green (ICG) angiography and multispectral reflectance imaging (MSRI) are technologies used to evaluate tissue perfusion.

Purpose of the Study:

• To investigate the hypothesis that ICG angiography overpredicts necrosis compared to MSRI.
• To compare the accuracy of ICG angiography and MSRI in predicting postoperative tissue necrosis.
• To determine if MSRI offers advantages over ICG angiography in assessing tissue viability.

Main Methods:

• Prospective cohort study of patients undergoing prepectoral direct implant reconstruction.
• Intraoperative assessment of tissue perfusion using both ICG angiography and MSRI.
• Postoperative follow-up for at least 2 months to monitor for signs of necrosis.

Main Results:

• ICG angiography incorrectly predicted necrosis in 84.6% of cases where tissue was viable.
• MSRI accurately predicted viability in 96.2% of cases and did not predict necrosis in any non-viable cases.
• No significant demographic differences were observed between groups predicted to have necrosis by ICG versus those predicted to have viable tissue.

Conclusions:

• ICG angiography tends to overpredict postoperative necrosis when compared to MSRI.
• MSRI demonstrates higher accuracy in predicting tissue viability and may reduce unnecessary tissue resection.