How MRI and CT predict flap failure after head and neck reconstructive cancer surgery
Author: Noah Fromson Source: labblog.uofmhealth.org A composite picture from MR perfusion of a free flap demonstrating measurements made within the flap. Credit: Michigan Medicine When a patient with head and neck cancer has surgery to remove it, they often need reconstructive surgery in the form of a “free flap”, which is skin and tissue taken from a different part of the body and connected to the blood vessels of the wound in need of repair. This free flap method, called microvascular reconstruction, carries around a 10-40% risk of wound complications, with 10% of cases requiring another surgery. A Michigan Medicine study finds that early postoperative CT scans and MRIs can help predict whether a flap will fail, which could allow surgeons to intervene earlier. The results are published in the American Journal of Neuroradiology. “All patients who have this procedure can be investigated with non-invasive post-operative CT or MRI perfusion, and these two methods show a lot of promise as accurate biomarkers of predicting free flap viability,” said Ashok Srinivasan, M.D., FACR, senior author of the paper and neuroradiologist at University of Michigan Health. “By seeing how much blood is flowing in and out of the tissue, we may be able to predict if the flap will succeed and if the patient can be discharged earlier, or it may be able to tell us sooner that surgical intervention is needed to repair the flap. Radiologists have used CT and MRI perfusion with contrast to look at blood perfusion [...]