University of Twente Student Theses
Virtual surgical planning in DIEP flap breast reconstructions : How to plan DIEP flap volume?
Karstanje, Eline (2024) Virtual surgical planning in DIEP flap breast reconstructions : How to plan DIEP flap volume?
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| Abstract: | Background: One in three women with breast cancer is treated with a mastectomy. A mastectomy can lead to a lowered quality of life, mostly related to a lower body image, for which asymmetry is an important factor. After a mastectomy multiple reconstruction options are possible. The most used option with autologous tissue is the deep inferior epigastric perforator (DIEP) flap. Reducing asymmetry after DIEP flap breast reconstruction can lead to a reduction of revisions, an improved body image and quality of life. Using pre-operative planning to determine the volume of the DIEP flap, could aid in improving the symmetry. This study focusses on a virtual planning for DIEP flap volume using CTA scans and a desired volume. Methods: A semi-automatic algorithm has been developed that determines the delineation of the abdominal incision based on manually chosen landmarks. The algorithm automatically attempts to reach the desired volume by iteratively changing the delineation and thus the corresponding DIEP flap volume. The predicted volume was validated using a retrospective and prospective feasibility study, with the aim of a maximum deviation of 10% compared to actual weight. The retrospective study (n=13) compared the surgically obtained weight of the flap to a virtual flap weight acquired using the delineation of the plastic surgeon which was transferred using a 3D scan. The prospective study (n=4) transferred the virtual planning to the patient using a 3D printed patient-specific mould. Results and discussion: The retrospective study resulted in a mean difference in weight between the virtual and actual flap of 11.9%. A significant correlation was found between the CTA age (days between acquiring the CTA and surgery) and the difference in weight, where a low CTA age resulted in an underestimation of weight. Furthermore, large error margins were observed in the dataset. The prospective study showed a difference in weight of less than 10% for all patients. The delineation of the planning was correct for two patients and was adjusted for the other two patients. Conclusion: A virtual planning for DIEP flap volume transferred using a 3D printed mould could predict the volume within a 10% deviation according to the feasibility study. However, more research is needed due to the small population. |
| Item Type: | Essay (Master) |
| Clients: | Medisch Spectrum Twente, Enschede, Netherlands Ziekenhuisgroep Twente, Hengelo, Netherlands |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/99958 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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