Infrared thermal imaging: A review of the literature and case report

Intraoperative Thermal Imaging (ITI) is a novel neuroimaging technique that can potentially locate the margins of primary and metastatic brain tumors. As a result, the additional real-time anatomical and pathophysiological information may significantly contribute to an improved extent of tumor resection. Our objectives in this article are i) to briefly discuss the current status of intraoperative imaging modalities including ITI and ii) to present a case report that evaluates the usefulness of ITI in detection of brain tumor and its margins. In this case report, ITI was used in a patient with a metastatic intracortical melanoma. The thermal profile of the tumor and surrounding normal cerebral cortex were mapped with a ThermaCAM P60 (TCP60) infrared camera by FLIR Systems. The data obtained by TCP60, intra-operatively, revealed a clear demarcation of tumor with significant temperature differences, up to 3.3 °C, between the tumor core (36.4 °C) and the surrounding normal tissue (33.1 °C). Ultrasound and pre-resection MR and CT confirmed the position and size of the metastasis. The volume of the tumor was preoperatively calculated using the CyberKnife™ software and postoperative volumetric measurement of the tumor residual was calculated by the Gamma Knife™ software. Our result, along with previously published results of others, suggests that thermal imaging could be used to provide a rapid, non-invasive, and real-time intra-operative imaging.