Cevik Jevan, Seth Ishith, Hunter-Smith David J, Rozen Warren M
Department of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, Australia.
Peninsula Clinical School, Central Clinical School, Faculty of Medicine, Monash University, Frankston, VIC 3199, Australia.
J Clin Med. 2023 Aug 11;12(16):5246. doi: 10.3390/jcm12165246.
Breast reconstruction is an essential component in the multidisciplinary management of breast cancer patients. Over the years, preoperative planning has played a pivotal role in assisting surgeons in planning operative decisions prior to the day of surgery. The evolution of preoperative planning can be traced back to the introduction of modalities such as ultrasound and colour duplex ultrasonography, enabling surgeons to evaluate the donor site's vasculature and thereby plan operations more accurately. However, the limitations of these techniques paved the way for the implementation of modern three-dimensional imaging technologies. With the advancements in 3D imaging, including computed tomography and magnetic resonance imaging, surgeons gained the ability to obtain detailed anatomical information. Moreover, numerous adjuncts have been developed to aid in the planning process. The integration of 3D-printing technologies has made significant contributions, enabling surgeons to create complex haptic models of the underlying anatomy. Direct infrared thermography provides a non-invasive, visual assessment of abdominal wall vascular physiology. Additionally, augmented reality technologies are poised to reshape surgical planning by providing an immersive and interactive environment for surgeons to visualize and manipulate 3D reconstructions. Still, the future of preoperative planning in breast reconstruction holds immense promise. Most recently, artificial intelligence algorithms, utilising machine learning and deep learning techniques, have the potential to automate and enhance preoperative planning processes. This review provides a comprehensive assessment of the history of innovation in preoperative planning for breast reconstruction, while also outlining key future directions, and the impact of artificial intelligence in this field.
乳房重建是乳腺癌患者多学科管理的重要组成部分。多年来，术前规划在协助外科医生在手术当天之前规划手术决策方面发挥了关键作用。术前规划的发展可以追溯到超声和彩色双功超声等检查手段的引入，这使外科医生能够评估供区的血管系统，从而更准确地规划手术。然而，这些技术的局限性为现代三维成像技术的应用铺平了道路。随着包括计算机断层扫描和磁共振成像在内的三维成像技术的进步，外科医生能够获得详细的解剖信息。此外，还开发了许多辅助手段来辅助规划过程。三维打印技术的整合做出了重大贡献，使外科医生能够创建复杂的潜在解剖触觉模型。直接红外热成像提供了对腹壁血管生理的非侵入性视觉评估。此外，增强现实技术有望通过为外科医生提供一个沉浸式和交互式环境来可视化和操作三维重建，从而重塑手术规划。尽管如此，乳房重建术前规划的未来仍充满巨大希望。最近，利用机器学习和深度学习技术的人工智能算法有潜力使术前规划过程自动化并得到改进。本综述全面评估了乳房重建术前规划的创新历史，同时概述了关键的未来方向以及人工智能在该领域的影响。
