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Preoperative Estimation of Deep Inferior Epigastric Perforator Flap Weight Using Synapse Vincent 3-dimensional
Nozomu Akamine1, Hajime Matsumine1, Hiroyuki Sakurai1
1From the Department of Plastic and Reconstructive Surgery, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Plastic and Reconstructive Surgery. Global Open
|August 22, 2025
Summary
Accurate estimation of deep inferior epigastric perforator (DIEP) flap weight is crucial for breast reconstruction. A new 3D imaging method using Synapse Vincent software provides a reliable and objective way to predict flap weight, improving surgical planning.
Area of Science:
- Plastic Surgery
- Medical Imaging
- Surgical Planning
Background:
- Accurate preoperative estimation of deep inferior epigastric perforator (DIEP) flap weight is critical for successful autologous breast reconstruction.
- Current methods for flap weight estimation are often subjective, relying on physical examination or surgeon experience.
Purpose of the Study:
- To develop and validate a simple, objective method for predicting DIEP flap weight using 3-dimensional (3D) image analysis software.
- To assess the accuracy and practicality of this novel method for surgical planning in breast reconstruction.
Main Methods:
- A prospective study involving 40 patients undergoing autologous breast reconstruction with DIEP flaps.
- Construction of a 3D model of abdominal subcutaneous tissue from preoperative computed tomography (CT) images using Synapse Vincent software.
- Conversion of the 3D model volume to predicted flap weight using a standard fat density (1.0 g/cm³), followed by correlation and regression analysis with actual intraoperative weights.
Main Results:
- A strong positive correlation was observed between predicted and actual DIEP flap weights (r = 0.938, P < 0.0001).
- The regression formula derived was: actual weight = 0.9391 × predicted weight + 68.98, with a coefficient of determination (R²) of 0.88.
- The method demonstrated high predictive accuracy, with a root mean square percentage error of 17%.
Conclusions:
- The developed method utilizing Synapse Vincent software enables accurate and practical preoperative estimation of DIEP flap weights.
- The software's ease of use, wide availability, and compatibility with standard CT imaging make it a valuable tool for enhancing surgical planning in DIEP flap breast reconstruction.
