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

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.

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.

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.

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.