Smartphone Thermal Imaging in the Detection of Testicular Ischemia

To evaluate smartphone thermal imaging as a point of care test in the detection of testicular ischemia. Thermal imaging detects the infrared (heat) pattern of an object and the technology is now available as an inexpensive attachment to smartphones. Smartphone thermal imaging was studied as a point-of-care diagnostic test for testicular ischemia in an IACUC approved study that prioritized survival of all animal subjects. Thirty canines weighing over 12 kg were observed during elective neuter procedures with consent from owners. Randomization determined ligation of the right vs left spermatic cord. With both testicles remaining in the scrotum, blinded inspection was performed with a FLIR ONE Pro thermal imaging camera for smartphone use. The bilateral orchiectomy procedures were then completed as planned. Within 11 minutes of ligation of the randomized spermatic cord, an obvious change in the thermal imaging pattern allowed for the correct diagnosis of the ischemic testicle in 30/30 (100%) of subjects in a blinded fashion. Temperature differences between testicles at the time of ischemia diagnosis ranged from 0.7°C to 3.7°C with an average difference of 1.79°C lower in the ischemic testicle (95% CI: [1.50, 2.08]). A thermal imaging evaluation of the testicles takes 30 seconds to perform. Smartphone thermal imaging correctly diagnosed testicular ischemia in 100% of animal subjects in a blinded fashion. The clinical utility of this emerging point-of-care technique in the evaluation of testicular torsion is currently unknown.