In this study the investigators plan to enroll a total of 25 evaluable volunteers (volunteer population) for the development and optimization of perforator imaging protocols and 50 evaluable clinical patients receiving flap procedures at OSUMC for the clinical validation of the optimized protocol. No extrinsic MR contrast agent will be injected. Clinical patients' MRI images will be evaluated independently by radiologists and plastic surgeons and compared to the clinical CTA images.
The overall objective of this pilot study is to develop and optimize preoperative MRA imaging protocols for various perforators commonly used in flap surgery with phantoms and healthy volunteers and to obtain clinical validation of the optimized protocols with a group of patients receiving flap surgery at The OSU Wexmer Medical Center. Data obtained in this study may also serve as the basis for statistical planning of future clinical trials. Based on previous experience with other magnetic resonance imaging (MRI) techniques, the investigators hypothesize that optimal MRA images can only be obtained with a carefully selected combination of imaging hardware, acquisition, and postprocessing factors. The main objective of this pilot study is to determine this optimal combination through the comparison of image between different combinations. The secondary objective of this pilot study is to evaluate, both qualitatively and quantitatively, the quality of the optimized MRA images and compare them with clinical CTA images. The primary hypothesis is that the quality of the optimized MRA images is at least comparable to that of the CTA images. The quantitative measurements obtained from this pilot population will also serve as the preliminary data for future studies and be used in statistical calculations that determine their study population.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
23
Study participants will be scanned with a 3.0 Tesla Phillips Ingenia CX whole body clinical MRI system located at the Wright Center of Innovation at The Ohio State University Medical Center. Anatomical and angiographic MR images will be acquired for one of the most commonly used flap surgery donor perforators including but not limited to: the deep inferior epigastric perforators (DIEP); the superior gluteal arter perforators (SGAP); the inferior gluteal artery perforators (IGAP); the thoracodorsal artery perforators (TDAP); the anterolateral thigh perforators (ATL).
Martha Morehouse Medical Plaza
Columbus, Ohio, United States
The Ohio State University Hospital
Columbus, Ohio, United States
image quality
assessed by blinded readers
Time frame: through study completion, on average 2-5 years
Artifacts in MRI images assessed by experienced readers
assessed by blinded readers
Time frame: through study completion, on average 2-5 years
Vessel detectability in MRI assessed by experienced readers
assessed by blinded readers
Time frame: through study completion, on average 2-5 years
Image noise as a measure of image quality assessed by quantitative measures
assessed region of interest over target tissue and background
Time frame: through study completion, on average 2-5 years
Anatomy accuracy
Location on images
Time frame: 60 min
Vascular network continuity
Location on images
Time frame: 60 min
Perforator branching pattern
Location on images
Time frame: 60 min
Potential Clinical Use of the MRI Images for Clinical Decision making
Clinical reader assessment
Time frame: Baseline
Signal-to-noise ratio (SNR)
ROI based assessment
Time frame: Baseline
Contrast-to-noise ratio (CNR) to muscle and fat
ROI based assessment
Time frame: Baseline
Perforator size
Location on images
Time frame: 60 min
Length of perforator intramuscular course
Location on images
Time frame: 60 min
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