Motion artifact suppression using speed detection in handheld laser speckle contrast imaging: first results in DIEP flap surgery

Objective: In Deep Inferior Epigastric Perforator (DIEP) flap breast reconstructions, early detection of perfusion issues is crucial to prevent complications. Laser Speckle Contrast Imaging (LSCI) is a promising, non-contact technique for real-time perfusion monitoring. A handheld LSCI device could improve usability, but motion artifacts (MA) remain a major challenge. This study applies a motion artifact correction (MAC) algorithm to handheld LSCI measurements in eight patients undergoing DIEP flap surgery. Methods: Perfusion was assessed intraoperatively at different surgical stages with handheld LSCI, and postoperatively with both handheld and mounted LSCI. Data acquisition was performed by simultaneous monochrome and color camera recording and marker-free motion tracking. MAC was performed using a linear extrapolation method. Results: Preliminary results show that motion artifacts lead to overestimated perfusion values in handheld LSCI. The MAC algorithm effectively reduced these errors, bringing handheld perfusion values closer to mounted values. However, differences between perfused and unperfused areas did not increase with our method due to the influence of MA. Conclusion: MAC application reduced perfusion values and improved correspondence with mounted measurements but remains suboptimal in areas with severe patient motion. Significance: This work demonstrates MAC in handheld LSCI for DIEP flap monitoring, marking a step toward more practical, real-time perfusion assessment. Future improvements could enhance clinical adoption, making handheld LSCI a valuable tool for postoperative monitoring and early intervention.