Detection of Perforators Using Smartphone Thermal Imaging

Abstract

Thermal imaging detects infrared radiation from an object, producing a thermogram that can be interpreted as a surrogate marker for cutaneous blood flow. To date, high-resolution cameras typically cost tens of thousands of dollars. The FLIR ONE is a smartphone-compatible miniature thermal imaging camera that currently retails at under $200. In a proof-of-concept study, patients and healthy volunteers were assessed with thermal imaging for (1) detecting and mapping perforators, (2) defining perforasomes, and (3) monitoring free flaps. Preoperative, intraoperative, and postoperative thermograms can assist in the planning, execution, and monitoring of free flaps, and the FLIR ONE provides a low-cost adjunct that could be applied to other areas of burns and plastic surgery.

Value of a smartphone‐compatible thermal imaging camera in the detection of peroneal artery perforators: Comparative study with computed tomography angiography

“…The perforators were categorized using the PABC classification system proposed by Yu . P, proximal perforators; A, perforators centering at a point of 0.51–0.52 (relative distance, distance from the fibular head divided by the length of the line connecting the fibular head and lateral malleolus); B, perforator centering at a point 0.58–0.62; C, more distally located perforators.…”

“…The temperature of the skin correlates with local blood supply; Arai first described this phenomenon over 40 years ago, demonstrating what we now refer to “hotspots” in thermography corresponding to the location of perforators . Previous studies have shown that dynamic infrared thermography (DIRT) was a valuable technique in assisting the planning, harvesting, and monitoring the free flaps . However, in the aforementioned studies, thermal images were captured by high‐resolution cameras, which usually cost tens of thousands of dollars.…”

“…With recent technology advancement, thermal imaging cameras are becoming smaller, affordable, and compatible. Hardwicke first introduced the detection of perforators in the anterior abdominal wall and lateral thigh using a smartphone‐compatible thermal imaging camera . However, their value in the detection of PAPs remains unclear.…”

“…19,20 Previous studies have shown that dynamic infrared thermography (DIRT) was a valuable technique in assisting the planning, harvesting, and monitoring the free flaps. [21][22][23][24][25][26][27][28][29] However, in the aforementioned studies, thermal images were captured by high-resolution cameras, which usually cost tens of thousands of dollars. The high capital investment makes this impractical for widespread use.…”

Detection of Perforators Using Smartphone Thermal Imaging

“…We read with interest the article by Hardwicke et al 1 on the concept of using low-cost thermal imaging for perforator identification. We agree with the authors that low-cost thermal imaging (thermoscan) provides an adjunct investigation because handheld Doppler has a 45% chance of producing a false positive overall 2 ; with an inexperienced surgeon, the number is even higher.…”