{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T23:59:50Z","timestamp":1774655990125,"version":"3.50.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In the era of supermicrosurgery, clinicians need more precise imaging modalities to know the exact microvascular and lymphatic anatomy of the patient. The goal of this review is to answer the research question \u201cWhat are the state-of-the-art medical imaging modalities supporting supermicrosurgery?\u201d<\/jats:p>\n                  <jats:p>This study is a scoping review and case report.<\/jats:p>\n                  <jats:p>Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are well-known current standard imaging modalities in flap surgery. In lymphatic surgery, lymphoscintigraphy is the gold standard. (Ultra)high-frequency ultrasound (UHFUS) has taken a major role in preoperative planning of flap surgery and lymphatic surgery. Practical guidelines on the use of UHFUS in flap planning and lymphatic surgery are described in this review article. Indocyanine green angiography and near-infrared fluorescent lymphography have also become key elements in modern flap surgery and lymphatic surgery. Moreover, contrast-enhanced magnetic resonance lymphography produces high-resolution imaging of superficial as well as deep lymphatic vessels. Laser tomography and photoacoustic imaging are promising experimental imaging techniques in lymphatic surgery.<\/jats:p>\n                  <jats:p>This review article describes and compares possible imaging modalities for preoperative planning and intraoperative guidance with the aims of enhancing surgical outcomes, reducing operative time, and preventing complications in supermicrosurgery. Moreover, a case report is described in order to illustrate the practical imaging work-up in daily practice.<\/jats:p>","DOI":"10.1055\/a-2798-0198","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T23:34:31Z","timestamp":1774654471000},"page":"178-190","source":"Crossref","is-referenced-by-count":0,"title":["State-of-the-Art Medical Imaging Supporting Supermicrosurgery: A Scoping Review, Practical Guidelines, and Illustrative Case Report"],"prefix":"10.1055","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4016-2237","authenticated-orcid":false,"given":"Jos","family":"Velleman","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospitals Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5873-3077","authenticated-orcid":false,"given":"Jin Geun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-7120","authenticated-orcid":false,"given":"Changsik John","family":"Pak","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1706-5516","authenticated-orcid":false,"given":"Hyunsuk Peter","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6208-9704","authenticated-orcid":false,"given":"Joon Pio","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Asan Medical Center, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1055\/s-0042-1751099","article-title":"The new imaging techniques in reconstructive microsurgery: A new revolution in perforator flaps and lymphatic surgery","volume":"49","author":"G Visconti","year":"2022","journal-title":"Arch Plast Surg"},{"issue":"04","key":"ref2","first-page":"227","article-title":"Imaging in reconstructive microsurgery - current standards and latest trends","volume":"8","author":"B Blank","year":"2024","journal-title":"Innov Surg Sci"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1002\/micr.20526","article-title":"Does the preoperative imaging of perforators with CT angiography improve operative outcomes in breast reconstruction?","volume":"28","author":"W M Rozen","year":"2008","journal-title":"Microsurgery"},{"issue":"02","key":"ref4","first-page":"164","article-title":"Comparative analysis of fluorescent angiography, computed tomographic angiography and magnetic resonance angiography for planning autologous breast reconstruction","volume":"4","author":"M P Chae","year":"2015","journal-title":"Gland Surg"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/SAP.0b013e31823b69a4","article-title":"The impact of preoperative CT angiography on breast reconstruction with abdominal perforator flaps","volume":"68","author":"W M Tong","year":"2012","journal-title":"Ann Plast Surg"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/SPA.0b013e318222b7b7","article-title":"Preoperative imaging for perforator flaps in reconstructive surgery: A systematic review of the evidence for current techniques","volume":"69","author":"G F Pratt","year":"2012","journal-title":"Ann Plast Surg"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1148\/radiology.175.3.2343107","article-title":"Adverse reactions to ionic and nonionic contrast media. 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