Bennink, B.A. (2026) Mind the cranial border: improving the accuracy of breast footprint delineation in Deep Inferior Epigastric Perforator flap reconstructions The breast footprint study. thesis, Medicine.
Full text available on request.Abstract
Background: In Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction, determining breast contour and flap volume is complex. A patient-specific three-dimensional (3D) breast mold may assist, but requires accurate and reproducible delineation of breast boundaries. Because no consensus exists on the optimal method, a new literature-based method was proposed. Objective: To assess agreement between the literature-based method and plastic surgeons’ delineations. Methods: This prospective, exploratory, and observational study included five patients scheduled for, or who had recently had, unilateral DIEP flap breast reconstruction. Two independent plastic surgeons delineated breast boundaries. These delineations were compared with the literature-based method using 3D imaging. Total and regional (cranial, caudal, medial, lateral) surface area differences were calculated and analysed using the Wilcoxon signed-rank test. Inter-rater reliability was assessed using the Intraclass Correlation Coefficient (ICC). Plastic surgeons evaluated the literature-based method using a questionnaire. Results: The literature-based method produced a larger total breast surface area in nine of ten comparisons, primarily in the cranial area. For surgeon one, differences were significant for total, cranial, medial, and lateral surface areas (Z = -2.023; p = 0.043); for surgeon two, only the cranial area differed significantly (Z = -2.023; p = 0.043). The ICC was highest medially (0.849) and lowest cranially (0.351). The cranial boundary was rated least favourable, but estimated flap volume was considered correct in 90% of assessments. Conclusion: The literature-based method shows potential for defining the breast footprint, although the cranial boundary requires refinement and validation. Given the small sample size, findings are exploratory
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Onna, M.A. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 Oct 2026 11:45 |
| Last Modified: | 19 Oct 2026 11:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3973 |
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