# Perioperative Diffuse Optical Imaging of Tissue Blood Flow and Oxygenation for Optimization of Mastectomy Skin Flap Viability

> **NIH NIH R01** · UNIVERSITY OF KENTUCKY · 2022 · $490,404

## Abstract

ABSTRACT
Mastectomy is performed on approximately half of women with breast cancer. Postmastectomy breast
reconstruction has benefits for body image, sexuality, self-esteem, and quality of life. Poor clinical prognoses
after breast reconstruction often involve mastectomy skin flap necrosis (MSFN) or other complications
associated with the lack of blood flow and oxygenation to wound tissue volumes. MSFN and wound dehiscence
leads to a number of challenges, including wound management problems, delays to adjuvant therapy, esthetic
compromise, implant extrusion, patient distress, and financial loss. A technology that allows surgeons to
perioperatively assess and optimize preservation of skin flaps while avoiding complications is essential to ensure
successful clinical outcomes. Although alternative techniques have been explored to identify ischemic-hypoxic
tissues at risk of necrosis, none have achieved universal acceptance as each technique has a few challenging
issues that decrease its clinical usefulness. Moreover, no single technique provides both blood flow and
oxygenation information, which are essential for precise assessment of skin flap viability. Our recent innovative
development of near-infrared speckle contrast diffuse correlation tomography (scDCT) technique provides a
noninvasive (dye-free) and noncontact means for continuous 2D/3D imaging of blood flow distributions
throughout large/thick tissue volumes such as mastectomy skin flaps. We propose to extend this scDCT
prototype to a next generation multi-wavelength scDCT (MW-scDCT) device for perioperative imaging of both
blood flow and oxygenation distributions in mastectomy skin flaps. New high-speed algorithms for 2D mapping
and 3D image reconstruction will be developed to accommodate rapid online assessment of skin flap
hemodynamics. This MW-scDCT system will be tested/optimized using standard tissue-simulating phantoms
(Aim 1) and calibrated/validated against a commercial dye-based fluorescence angiography device (SPY Elite®)
in swine (Aim 2) and patients (Aim 3) undergoing mastectomy with expander-implant based breast
reconstruction. The in vivo studies will determine the capability of our MW-scDCT for intraoperative prediction of
MSFN regions/volumes and postoperative optimization of incremental expander volumes to reduce risks of
MSFN and other complications. We expect that combined measurements of preoperative baseline and
intraoperative alteration in skin flap flow and oxygenation will provide a more accurate assessment of skin flap
viability than a one-time single-parameter measurement (i.e., blood flow, blood oxygenation, or fluorescence
perfusion). Study outcomes will provide the rationale for designing MW-scDCT guided clinical trials of
mastectomy with breast reconstruction to reduce postoperative complications and healthcare costs. Moreover,
this noninvasive (dye-free), noncontact, continuous, and cost-efficient imaging system has the potential for
perioperative use in many...

## Key facts

- **NIH application ID:** 10127643
- **Project number:** 5R01EB028792-02
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Guoqiang Yu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $490,404
- **Award type:** 5
- **Project period:** 2020-03-15 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10127643

## Citation

> US National Institutes of Health, RePORTER application 10127643, Perioperative Diffuse Optical Imaging of Tissue Blood Flow and Oxygenation for Optimization of Mastectomy Skin Flap Viability (5R01EB028792-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10127643. Licensed CC0.

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