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J Am Coll Radiol. 2017 Nov;14(11S):S456-S461. doi: 10.1016/j.jacr.2017.08.047.

ACR Appropriateness Criteria® Imaging of Deep Inferior Epigastric Arteries for Surgical Planning (Breast Reconstruction Surgery).

Author information

1
Principal Author, Yale University School of Medicine, New Haven, Connecticut. Electronic address: isabel.oliva@yale.edu.
2
Research Author, Stanford University, Stanford, California.
3
Panel Chair, UMass Memorial Medical Center, Worcester, Massachusetts.
4
Panel Vice Chair, University of Virginia Health System, Charlottesville, Virginia.
5
Rush University Medical Center, Chicago, Illinois.
6
University of Chicago, Chicago, Illinois.
7
University of Pennsylvania, Philadelphia, Pennsylvania.
8
H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
9
Palos Community Hospital, Palos Heights, Illinois.
10
Princeton Plastic Surgeons, Princeton, New Jersey; American College of Surgeons.
11
Brigham & Women's Hospital, Boston, Massachusetts.
12
Baylor College of Medicine, Houston, Texas.
13
University of Florida, Gainesville, Florida.
14
Specialty Chair, Ottawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada.

Abstract

Breast cancer is the most common malignancy in women in the United States. Breast reconstruction surgery is a commonly used therapy for patients with breast cancer. The technique for the deep inferior epigastric perforator flap uses a preserved rectus muscle, which decreases donor site morbidity. Accurate identification and measurement of the perforator branches of the deep inferior epigastric artery is pivotal during pre-operative planning so that the surgeon can prioritize the best vessel to use and ultimately improve clinical outcome. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

KEYWORDS:

AUC; Appropriate Use Criteria; Appropriateness Criteria; Breast cancer; Breast reconstruction surgery; Deep inferior epigastric artery; Deep inferior epigastric perforator

PMID:
29101984
DOI:
10.1016/j.jacr.2017.08.047
[Indexed for MEDLINE]

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