Wong KK, et al. - A modified Delphi approach was utilized, including a panel of 13 microsurgery experts across North America to collect an expert reconstructive surgical judgment in order to describe and rank the surgically most significant anatomy and give guidance for report content to radiologists when seeing a preoperative CT angiography (CTA). For each of the three survey rounds, response rates were 62%, 77%, and 69%, respectively. The panel recognized that the diameter of the vein, perforator location within the flap, and diameter of the artery, respectively are the most significant perforator features in choosing the optimal perforator. The pronounced preference was for perforators located below the umbilicus. If no suitable perforator was found below the umbilicus, the panel would acknowledge perforators up to 2 cm above the umbilicus. The size of the perforator vein, perforator location relative to landmarks, and the size of the perforator artery were the most significant considerations for the preoperative radiology planning report. Thus, on the basis of the panel of expert reconstructive microsurgeons, the most surgically relevant anatomical considerations to be evaluated and involved in preoperative CTA reports for DIEP flap breast reconstruction were ascertained. The suggestions for reporting of preoperative DIEP breast reconstructions are presented, which, in discussion with local surgeons, could be utilized to create a template for reporting.