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79 for PET/CT compared to 0.64 for MRI (P= .044). Categorization of "Likely" primary site recurrence on PET/CT, versus MRI, had higher sensitivity (0.63 vs. 0.4, but lower specificity (0.90 vs. 1.. MRI demonstrated higher sensitivity (1.0 vs. 0.78) at detecting regional site recurrences. PET/CT demonstrates greater sensitivity than MRI as a surveillance tool for primary site recurrence following microvascular reconstruction where clinical evaluation is hindered by anatomical distortion. Therefore, PET/CT should be pursued as first-lin