Work

Implications of a New Generation of Tissue Expanders for Post-Mastectomy Radiotherapy in Breast Reconstruction: A Retrospective Single-Center Study

Year: 2026

Type: article

Abstract: Background: Tissue expanders with metallic ports are commonly used in postmastectomy breast reconstruction but can produce significant CT artifacts, which impair accurate de-lineation of target volumes during radiotherapy planning. The Motiva Flora® expander incorporates an integrated RFID (radiofrequency identification) valve, designed to be magnet-free and MRI-conditional, potentially minimizing image distortion and im-proving the precision of treatment planning. This pilot study aims to quantitatively compare the extent of CT image distortion observed in radiotherapy simulation scans between conventional metallic-valve expanders and RFID-valve expanders, evaluating their impact on radiotherapy planning quality. Methods: Between January 2024 and September 2025, fourteen consecutive patients who underwent postmastectomy two-stage breast reconstruction followed by adjuvant RT at Hospital Santa Maria della Misericordia (Udine, Italy) were included. Seven patients received Motiva Flora® tissue expanders with a non-metallic RFID port, and seven received Mentor CPX4® expanders with a conventional metallic port. The volume of areas with a significant level of artifacts (Artifact Volume) was quantitatively evaluated by delineating the CT image area of distortion caused by the valve. Moreover, a comparison of the ratio between artifact volume and Clinical Target Volume (Artifact volume/CTV volume) between expander types to assess potential imaging-related distortions has been made. Group comparisons of volume ratio were performed using Welch’s t-test. Results: Patients reconstructed with Motiva Flora® showed a mean artifact volume of 24.5 ± 10.3 cc, whereas those with Mentor CPX4® expanders presented a mean artifact volume of 64.2 ± 38.1 cc. The ratio between artifact volume and Clinical Target Volume (CTV) was lower in patients reconstructed with Motiva expanders compared to those reconstructed with Mentor expanders and this difference resulted significative at the Wilch’s t-test (p=0.046). Conclusions: The reduced CT distortion observed with the RFID valve–equipped Motiva Flora suggests a superior radiological compatibility compared to conventional metallic-port expanders, with po-tential to enhance the accuracy of radiotherapy planning.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15114224

Authors: Caputo Glenda G., Anna Scarabosio, Pisano Gaetano, Giunco Carmen, Prisco Agnese, Moretti Eugenia

Institution: Azienda sanitaria universitaria Friuli Centrale

Language: English

Topic: Breast Implant and Reconstruction

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137