Clinical Feasibility of a Low-dose Computed Tomography Angiography Protocol with an Iterative Reconstruction Algorithm in Preoperative Examinations for Anterolateral Thigh Perforator Flap Surgery

Background: In the past several years, emerging imaging techniques, such as computed tomography angiography (CTA), Doppler ultrasound, and magnetic resonance (MRI), have been used for investigating anatomy perfusion of perforator complexes. Preoperative CTA can provide explicit information on flaps, which not only helps surgeons to evaluate optimal design flaps with respect lateral circumflex femoral artery (LCFA) territory concomitant venous drainage pattern, but also reduces postoperative complications secondary operation rates. Objectives: This study aimed clinical feasibility a low-dose protocol adaptive statistical iterative reconstruction (ASIR) patients scheduled anterolateral thigh flap (ALTPF) surgery. Patients Methods: prospective randomized controlled trial was conducted in single institution from August 2016 July 2017. A total 60 inpatients ALTPF surgery were randomly allocated into three groups (n = 20 per group): Group A, filtered back projection (FBP) tube voltage 120 kVp; group B, ASIR 100 C, 80 kVp. The vessel attenuation value, signal-to-noise ratio (SNR), contrast-to-noise (CNR), figure merit (FOM) compared between groups. Additionally, four-point Likert scale subjective quality images. scan length, dose-length product (DLP), CT dose index (CTDI), effective (ED) recorded compared. Results: age, sex, body mass (BMI) significantly different (P > 0.05 all). FOM images segments higher C other two < 0.001 results evaluation revealed no poor-quality images, score did differ Compared significant reductions observed CTDI, DLP, ED C. Conclusion: 80-kVp reduced radiation dose, exhibited lower performance 120-kVp FBP ASIR; it yielded relatively satisfactory image quality.