title: SPY-Q analysis toolkit values potentially predict mastectomy flap necrosis.
abstract: BACKGROUND
  Previously, we and other investigators have reported the benefits of using SPY Intraoperative Perfusion Assessment System to assist in the prediction of mastectomy flap necrosis. To date, analysis of the SPY images has been subjective. However, the new SPY-Q postprocessing software allows for objective quantification of SPY images through the application of absolute and relative values of fluorescence intensity. This study seeks to determine the use of these objective, numerical data and their role in potentially predicting mastectomy flap necrosis.
  
  
  METHODS
  In a retrospective fashion, 20 SPY images from immediate breast reconstructions were randomly selected from a database of more than 100 images: 10 from breasts that developed flap necrosis and 10 from breasts that demonstrated adequate healing. Groups were matched for age, body mass index, and comorbidities. The points of necrosis and points of adequate healing were evaluated using the postprocessing software, and the groups were compared.
  
  
  RESULTS
  The mean "relative" fluorescence of the necrosis and the adequate healing groups was 25.2% and 43.3%, respectively (P < 0.001). The mean absolute fluorescence of the 2 groups was 18.5 and 25.0, respectively (P = 0.07).
  
  
  CONCLUSIONS
  These findings suggest that quantitative "relative" perfusion values as generated by the postprocessing software may augment clinical judgment of flap viability in an objective and reproducible fashion.
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA. newmanm@ccf.org
authors.forename: Martin I
authors.initials: MI
authors.lastname: Newman
authors.forename: Megan C
authors.initials: MC
authors.lastname: Jack
authors.forename: Michel C
authors.initials: MC
authors.lastname: Samson
mesh_terms: D003661:Decision Support Techniques; D005260:Female; D005456:Fluorescent Dyes; D006085:Graft Survival; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007208:Indocyanine Green; D007430:Intraoperative Care / Q000379:methods*; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D009336:Necrosis / Q000175:diagnosis / Q000209:etiology; D061848:Optical Imaging; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D018570:Risk Assessment; D012984:Software; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green