Dynamic InfraRed Thermography (DIRT) in DIEP-flap breast reconstruction: A review of the literature

Thiessen, Filip; Tondu, Thierry; Cloostermans, Ben; Dirkx, Yarince; Auman, Dorien; Cox, Stefaan; Verhoeven, Véronique; Hubens, Guy; Steenackers, Gunther; Tjalma, Wiebren A.A.

doi:10.1016/j.ejogrb.2019.08.008

Cited by 30 publications

(34 citation statements)

References 22 publications

(95 reference statements)

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“…1,2,11,12 They have also been used to identify vascular perforators and flap integrity intraoperatively. [5][6][7][8][9] The application of thermal imaging technology or many other flap monitoring techniques involve the use of equipment with significant cost in the medical device marketplace.…”

Section: Discussionmentioning

confidence: 99%

“…Another systematic review on the use of infrared thermography to find dominant vessels while harvesting DIEP (deep inferior epigastric artery perforator) flaps found it to be beneficial as an intraoperative tool. 8 An additional study utilized a portable infrared thermography device to identify perforators of the anterolateral thighs of three volunteer subjects. 9 These support our hypothesis that this technology can be used to monitor free flaps in the postoperative period.…”

Section: Introductionmentioning

confidence: 99%

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Thermal imaging for microvascular free tissue transfer monitoring: Feasibility study using a low cost, commercially available mobile phone imaging system

et al. 2020

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Background The use of infrared thermography to evaluate the perfusion of tissue flaps have been studied. This study aims to evaluate the utility of thermal imaging for flap monitoring with a low‐cost, readily available smartphone imaging device. Methods Adult subjects who underwent head and neck reconstruction using a microvascular free flap with a cutaneous paddle were recruited. Thermal images were taken of the free flap before, during and after anastomosis. Thermal images were analyzed by measuring the average flap temperature minus the average surrounding tissue temperature (dT). Results Twenty‐one patients were enrolled. The mean dT for flaps intraoperatively prior to anastomosis was −11.47 °F. For 20 patients, dT averaged between −0.30 to 0.12 °F. One flap was inadequately perfused and dT was found to be −4.35 °F. Conclusions Low cost, mobile smartphone devices such as the thermal camera may provide an objective method of monitoring microvascular free flaps. Level of evidence 2 Prospective Cohort Study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Thermal imaging for microvascular free tissue transfer monitoring: Feasibility study using a low cost, commercially available mobile phone imaging system

et al. 2020

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“…Of note, some authors recommend using dynamic infrared thermography, where skin is cooled before thermal imaging, for identification of cutaneous perforators with high reperfusion rates, which may indicate increased vessel flow and diameter. 26 – 35 …”

Section: Discussionmentioning

confidence: 99%

High-end versus Low-end Thermal Imaging for Detection of Arterial Perforators

Obinah

Nielsen

Hølmich

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Thermal imaging was first reported as a method for detection of arterial perforators in 1968 and has since been shown to be an extremely accurate way to assess perforators with an audible Doppler signal, using high-end professional thermal cameras. This technology has recently become easily accessible with the advent of smartphone-compatible, low-end thermal cameras. Several groups have reported on the use of these devices in the pre-, intra-, and postoperative phase, yet there have been few attempts to validate them against existing methods or compare them with high-end thermal cameras. Methods: The aim of this study was to compare a low-end smartphone-compatible thermal camera, the FLIR ONE Pro (ONEPro), priced US $400, with a high-end thermal camera the FLIR A35sc (A35sc), priced US $5000, for the detection of arterial perforators on the anterolateral thigh, using a handheld Doppler and Color Doppler Ultrasound to verify the results. Results: We examined 23 thighs in 13 healthy volunteers and identified a total of 779 hotspots using both cameras. The A35sc identified on average 33.5 hotspots per thigh. The ONEPro identified on average 31.5 hotspots per thigh. Using a handheld Doppler, we confirmed 95.9% of hotspots identified with the ONEPro and 95.8% of hotspots identified with the A35sc. Using Color Doppler Ultrasound, we confirmed 95% of hotspots identified using the ONEPro and 94.9% of hotspots identified with the A35sc. Conclusion: While the high-end camera identified slightly more hotspots, verification data were very similar for the 2 cameras, and for clinical purposes these differences are negligible.

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“…The use of AI will improve reproducibility and decrease time-consuming human input in perforator selection [ 1 ]. Dynamic Infrared Thermography (DIRT) can be an alternative technique in perforator mapping and perfusion assesment [ 4 , 5 ]. DIRT is less invasive than CTA as it does not use radiation nor contrast agents [ [4] , [5] , [6] , [7] ].…”

mentioning

confidence: 99%

“…Dynamic Infrared Thermography (DIRT) can be an alternative technique in perforator mapping and perfusion assesment [ 4 , 5 ]. DIRT is less invasive than CTA as it does not use radiation nor contrast agents [ [4] , [5] , [6] , [7] ]. We developed a standardized measuremet set-up for the use of DIRT during breast reconstruction with perforator flaps [ 8 ].…”

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confidence: 99%

Automatic detection of perforators for microsurgical reconstruction

et al. 2020

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We read with interest the article by Mavioso et al. this is a valuable pilot study on the use of artificial intelligence (AI) in preoperative mapping of perforators with computed tomography (CTA) [1]. Selection of the best perforators is of uttermost importance, as it is the only source of blood supply to the flap. This selection reduces operative time, lower complication rates and ensure an overall better result [2]. The current gold standard for perforator selection is CTA but it has disadvantages: use of intravenous (IV) contrast agents and ionizing radiation, high purchasing costs, a lack of perioperative usability, and a lack of physiological information on flow characteristics [3]. The use of AI will improve reproducibility and decrease time-consuming human input in perforator selection [1]. Dynamic Infrared Thermography (DIRT) can be an alternative technique in perforator mapping and perfusion assesment [4,5]. DIRT is less invasive than CTA as it does not use radiation nor contrast agents [4e7]. We developed a standardized measuremet set-up for the use of DIRT during breast reconstruction with perforator flaps [8]. With this set-up AI can potentialy be an interesting tool in assessing perforators and perfusion pre-, per-and postoperatively with DIRT.

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Dynamic InfraRed Thermography (DIRT) in DIEP-flap breast reconstruction: A review of the literature

Cited by 30 publications

References 22 publications

Thermal imaging for microvascular free tissue transfer monitoring: Feasibility study using a low cost, commercially available mobile phone imaging system

Thermal imaging for microvascular free tissue transfer monitoring: Feasibility study using a low cost, commercially available mobile phone imaging system

High-end versus Low-end Thermal Imaging for Detection of Arterial Perforators

Automatic detection of perforators for microsurgical reconstruction

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