Computer aided detection of deep inferior epigastric perforators in computed tomography angiography scans.

Autor: Araújo RJ; INESC TEC, Campus da Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; Faculdade de Ciências da Universidade do Porto, Rua do Campo Alegre, 4169-007 Porto, Portugal., Garrido V; Breast Unit, Champalimaud Clinical Center, Avenida de Brasília, 1400-038 Lisboa, Portugal., Baraças CA; Hospital Pedro Hispano, Rua Dr. Eduardo Torres, 4464-513 Senhora da Hora, Portugal., Vasconcelos MA; Breast Unit, Champalimaud Clinical Center, Avenida de Brasília, 1400-038 Lisboa, Portugal., Mavioso C; Breast Unit, Champalimaud Clinical Center, Avenida de Brasília, 1400-038 Lisboa, Portugal., Anacleto JC; Breast Unit, Champalimaud Clinical Center, Avenida de Brasília, 1400-038 Lisboa, Portugal., Cardoso MJ; Breast Unit, Champalimaud Clinical Center, Avenida de Brasília, 1400-038 Lisboa, Portugal; Nova Medical School, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal., Oliveira HP; INESC TEC, Campus da Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal; Faculdade de Ciências da Universidade do Porto, Rua do Campo Alegre, 4169-007 Porto, Portugal.
Jazyk: angličtina
Zdroj: Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society [Comput Med Imaging Graph] 2019 Oct; Vol. 77, pp. 101648. Date of Electronic Publication: 2019 Aug 18.
DOI: 10.1016/j.compmedimag.2019.101648
Abstrakt: The deep inferior epigastric artery perforator (DIEAP) flap is the most common free flap used for breast reconstruction after a mastectomy. It makes use of the skin and fat of the lower abdomen to build a new breast mound either at the same time of the mastectomy or in a second surgery. This operation requires preoperative imaging studies to evaluate the branches - the perforators - that irrigate the tissue that will be used to reconstruct the breast mound. These branches will support tissue viability after the microsurgical ligation of the inferior epigastric vessels to the receptor vessels in the thorax. Usually through a computed tomography angiography (CTA), each perforator is manually identified and characterized by the imaging team, who will subsequently draw a map for the identification of the best vascular support for the reconstruction. In the current work we propose a semi-automatic methodology that aims at reducing the time and subjectivity inherent to the manual annotation. In 21 CTAs from patients proposed for breast reconstruction with DIEAP flaps, the subcutaneous region of each perforator was extracted, by means of a tracking procedure, whereas the intramuscular portion was detected through a minimum cost approach. Both were subsequently compared with the radiologist manual annotation. Results showed that the semi-automatic procedure was able to correctly detect the course of the DIEAPs with a minimum error (average error of 0.64 and 0.50 mm regarding the extraction of subcutaneous and intramuscular paths, respectively), taking little time to do so. The objective methodology is a promising tool in the automatic detection of perforators in CTA and can contribute to spare human resources and reduce subjectivity in the aforementioned task.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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