The deep inferior epigastric artery perforator (DIEAP) flap is the most common free flap used for breast reconstruction after a mastectomy. It makes use of the skin and fat of the lower abdomen to build a new breast mound either at the same time of the mastectomy or in a second surgery. This operation subcutaneous region of each perforator was extracted, by means of a tracking procedure, whereas the intramuscular portion was detected through a minimum cost approach. Both were subsequently compared with the radiologist manual annotation.Results showed that the semi-automatic procedure was able to correctly detect the course of the DIEAPs with a minimum error (average error of 0.64 mm and 0.50 mm regarding the extraction of subcutaneous and intramuscular paths, respectively). The objective methodology is a promising tool in the automatic detection of perforators in CTA and can contribute to spare human resources and reduce subjectivity in the aforementioned task.
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