Prediction of Mastectomy Skin Flap Necrosis With Indocyanine Green Angiography and Thermography: A Retrospective Comparative Study

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2024-09-04 DOI:10.1016/j.clbc.2024.08.024

Domenico Pagliara , Pietro Luciano Serra , Nicola Pili , Francesco Ruben Giardino , Federica Grieco , Laurenza Schiavone , Melba Lattanzi , Corrado Rubino , Diego Ribuffo , Giorgio De Santis , Marzia Salgarello , Maurice Y. Nahabedian , Alberto Rancati

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引用次数: 0

Abstract

Objective

This study investigates the predictive role of indocyanine green angiography and thermography in assessing mastectomy skin flap necrosis in the intraoperative and postoperative setting.

Methods

A retrospective review of 45 patients who underwent nipple-sparing mastectomy and immediate prepectoral reconstruction was performed. Mastectomy flap viability was evaluated intraoperatively with indocyanine green angiography and thermography after placement of an implant sizer and again postoperatively at 24 hours. Fluorescence pattern was analyzed with a near-infrared camera (IC-Flow^TM Imaging System, Diagnostic Green GmbH, Germania) and thermographic images with FLIR ONE device. FLIR ONE and ICG images were then transposed on macroscopic breast images with a scale 1:1. The mastectomy skin flap was evaluated using the SKIN score (Mayo Clinic Classification).

Results

Overlap between angiography and thermography images was 87.95% intraoperatively and 95.95% 24 hours postoperatively. Overlay with mastectomy flap necrosis was higher in the intraoperative angiography group with statistical significance. Contrarily, such a difference was not apparent in the postoperative period.

Conclusions

ICG appears to be a superior tool when used intraoperatively with fundamental implications on reconstructive decision-making, while thermography could be a valuable assessment method in the postoperative setting. Further studies are necessary to confirm such results and determine their clinical applicability.

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用吲哚菁绿血管造影和热成像预测乳房切除术皮瓣坏死：回顾性比较研究

目的本研究探讨了吲哚菁绿血管造影和热成像在评估术中和术后乳房切除皮瓣坏死方面的预测作用：方法：对45名接受乳头保留乳房切除术并立即进行胸前重建的患者进行回顾性研究。术中使用吲哚菁绿血管造影术和热成像术评估乳房切除瓣的存活率，术后 24 小时再次进行评估。用近红外相机（IC-FlowTM 成像系统，Diagnostic Green GmbH，日耳曼）分析荧光模式，用 FLIR ONE 设备分析热成像图像。然后将 FLIR ONE 和 ICG 图像转换到比例为 1:1 的宏观乳房图像上。使用 SKIN 评分（梅奥诊所分类）对乳房切除皮瓣进行评估：结果：血管造影和热成像图像的术中重叠率为 87.95%，术后 24 小时重叠率为 95.95%。术中血管造影组乳房切除皮瓣坏死的重叠率较高，且有统计学意义。结论：ICG在术中使用时似乎是一种更优越的工具，对重建决策具有根本性的影响，而热成像在术后环境中可能是一种有价值的评估方法。有必要进行进一步研究，以确认这些结果并确定其临床适用性。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.