The application of infrared thermography in the assessment of patients with coccygodynia before and after manual therapy combined with diathermy.
Wu CL, Yu KL, Chuang HY, Huang MH, Chen TW, Chen CH. Source Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Abstract
OBJECTIVE: This study examines the potential usefulness of a novel thermal imaging technique in the assessment of local physiologic responses before and after conservative therapies for coccygodynia.
METHODS: Patients with coccygodynia were selected on the basis of detailed history taking, clinical examination, and dynamic series radiography. They underwent therapeutic modalities consisting of 6 to 8 sessions of manual medicine treatments (massage of the levators followed by Maigne's manipulative technique) and external physiotherapy (short-wave diathermy) 3 times a week for 8 weeks. We performed the assessments with numeric pain rating scale (NPRS) and infrared thermography (IRT) before treatment and at 12 weeks.
RESULTS: A total of 53 patients (6 males and 47 females) ranging from 18 to 71 years of age and clinically diagnosed with coccygodynia received the full course of therapy and assessments. There were significant differences in both NPRS and surface temperature obtained by IRT in the 12-week follow-up (P < .05). The correlation between NPRS improvement and temperature decrement was significantly high (r = 0.67, P < .01).
CONCLUSIONS: The study shows that IRT can objectively show the decrement of surface temperatures correlating with changes in subjective pain intensity after treatment of coccygodynia. With the advantages of being painless, noninvasive, and easy to repeat, IRT appears to be useful as a quantifiable tool for monitoring the dynamics of the disease activity in coccygodynia.
Tuesday, April 30, 2013
Monday, April 29, 2013
Images
in plastic surgery: digital thermographic photography ("thermal
imaging") for preoperative perforator mapping.
Chubb D, Rozen WM, Whitaker IS, Ashton MW.
The Taylor Laboratory, Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria 3050, Australia.
Preoperative imaging to identify the location of individual perforators has been shown to improve operative outcomes, and while computed tomographic angiography (CTA) and magnetic resonance angiography are currently the most widely used modalities, these have substantial limitations. Such limitations include the need for intravenous access, the need for iodinated contrast media, radiation exposure with CTA, and long scanning times with magnetic resonance angiography. Complications from the use of contrast media are also noteworthy, and can include anaphylactoid reactions and renal toxicity. In a move to avoid these problems, we have recently introduced a technique that is readily available and easy to implement for preoperative imaging, and may show an accuracy that matches the more advanced imaging modalities. Thermal imaging is a readily performed technique, and can be undertaken by the reconstructive surgeon themselves at the initial consultation, enabling prompt operative planning, and avoiding the need for delays in imaging, confusion in the interpretation of a radiologist report, and the need for an intermediary radiologist altogether. In our experience thus far, the technique matches the accuracy for location of CTA, and a larger clinical trial of the technique is underway.
Chubb D, Rozen WM, Whitaker IS, Ashton MW.
The Taylor Laboratory, Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria 3050, Australia.
Preoperative imaging to identify the location of individual perforators has been shown to improve operative outcomes, and while computed tomographic angiography (CTA) and magnetic resonance angiography are currently the most widely used modalities, these have substantial limitations. Such limitations include the need for intravenous access, the need for iodinated contrast media, radiation exposure with CTA, and long scanning times with magnetic resonance angiography. Complications from the use of contrast media are also noteworthy, and can include anaphylactoid reactions and renal toxicity. In a move to avoid these problems, we have recently introduced a technique that is readily available and easy to implement for preoperative imaging, and may show an accuracy that matches the more advanced imaging modalities. Thermal imaging is a readily performed technique, and can be undertaken by the reconstructive surgeon themselves at the initial consultation, enabling prompt operative planning, and avoiding the need for delays in imaging, confusion in the interpretation of a radiologist report, and the need for an intermediary radiologist altogether. In our experience thus far, the technique matches the accuracy for location of CTA, and a larger clinical trial of the technique is underway.
Wednesday, April 17, 2013
Evaluation of
provocation test monitoring palmoplantar temperature with the use of thermography for diagnosis of focal
tonsillar infection in palmoplantar pustulosis.
Asada H, Miyagawa S, Tamura M, Azukizawa H, Tanemura A, Yamaguchi Y, Sumikawa Y, Itami S, Kubo T,Yoshikawa K.
Source
Department of Dermatology, Nara Medical University, 840 Shijo-cho Kashihara, 634-8522,
Nara, Japan. asadah@naramed-u.ac.jp
Abstract
BACKGROUND:
Since focal tonsillar
infections are often associated with palmoplantar pustulosis (PPP), provocation
tests have been performed for preoperative evaluation of tonsillectomy.
However, these tests have not been fully established.
OBJECTIVES:
To introduce a more sensitive operative indication for
tonsillectomy to the patients with PPP, we have monitored the temperature after
provocation tests at palmoplantar sites, as measured by thermography, and we hypothesized that this methodology may
lead to a more sensitive marker for tonsillectomy.
METHODS:
Twenty-two PPP patients with/without clinical tonsillitis were
included in this study. After mechanical tonsillar massage, using infrared thermography, we have monitored the surface temperature at
palmoplantar sites of 22 patients with PPP, five chronic tonsillitis patients
without PPP, and four healthy controls, to compare the findings with the skin
lesional outcome after tonsillectomy.
RESULTS:
There was a significant relationship between the effects of
tonsillectomy and the results of provocation tests assessed by thermography. The sensitivity, specificity, and efficiency
of the provocation tests with thermography of detecting a favorable outcome of tonsillectomy were 75.0, 83.3,
and 77.3%, respectively, while those of the provocation tests as estimated with
the conventional criteria were 37.5, 83.3, and 50.0%, respectively.
CONCLUSION:
Our results suggest that
a new indicator using non-invasive thermography for the provocation tests is useful in
predicting the effects of tonsillectomy for PPP.
Tuesday, April 16, 2013
Imaging of the vulnerable plaque: new modalities.
Bhatia V, Bhatia R, Dhindsa S, Dhindsa M.; Department of Internal Medicine, State University of New
York at Buffalo, Buffalo, NY, USA.
Atherosclerosis is currently considered to be an inflammatory and thus a systemic disease affecting
multiple arterial beds. Recent advances in intravascular imaging have shown multiple sites of
atherosclerotic changes in coronary arterial wall. Traditionally, angiography has been used to detect and
characterize atherosclerotic plaque in coronary arteries, but recently it has been found that plaques that
are not significantly stenotic on angiography cause acute myocardial infarction. As a result, newer
imaging and diagnostic modalities are required to predict which of the atherosclerotic plaque are prone to
rupture and hence distinguish "stable" and "vulnerable" plaques. Intravascular ultrasound can identify
multiple plaques that are not seen on coronary angiography. Thermography has shown much promise
and is based on the concept that the inflammatory plaques are associated with increased
temperature and can also identify "vulnerable patients." Of all these newer modalities, magnetic
resonance imaging has shown the most promise in identification and characterization of vulnerable
plaques. In this article, we review the newer coronary artery imaging modalities and discuss the
limitations of traditional coronary angiography.
Monday, April 15, 2013
Dynamic infrared imaging of cutaneous melanoma and normal skin in patients treated with BNCT.
Santa Cruz GA, Bertotti J, Marín J, González SJ, Gossio S, Alvarez D, Roth BM, Menéndez P, Pereira MD, Albero M, Cubau L, Orellano P, Liberman SJ. Dpto. de Instrumentación y Control, Comisión Nacional de Energía Atómica, Av. del Libertador 8250 (1429), Buenos Aires, Argentina. santacr@cnea.gov.ar
We recently initiated a program aimed to investigate the suitability of dynamic infrared imaging for following-up nodular melanoma patients treated with BNCT. The reason that makes infrared imaging attractive is the fact that it constitutes a functional and non-invasive imaging method, providing information on the normal
and abnormal physiologic response of the nervous and vascular systems, as well as the local metabolic rate and inflammatory processes that ultimately appear as differences in the skin temperature. An infrared camera, with a focal plane array of 320 x 240 uncooled ferroelectric detectors is employed, which provides a video
stream of the infrared emission in the 7-14 microm wavelength band. A double blackbody is used as reference for absolute temperature calibration. After following a protocol for patient preparation and acclimatization, a basal study is performed. Subsequently, the anatomic region of interest is subjected to a provocation test (a cold stimulus), which induces an autonomic vasoconstriction reflex in normal structures, thus enhancing the thermal contrast due to the differences in the vasculature of the different skin regions. Radiation erythema reactions and melanoma nodules possess typically a faster temperature recovery than healthy, non-irradiated skin. However, some other non-pathological structures are also detectable by infrared imaging, (e.g. scars, vessels, arteriovenous anastomoses and injuries), thus requiring a multi-study comparison in order to discriminate the tumor signal. Besides the superficial nodules, which are readily noticeable by infrared imaging, we have detected thermal signals that are coincident with the location of
non-palpable nodules, which are observable by CT and ultrasound. Diffuse regions of fast temperature recovery after a cold stimulus were observed between the third and sixth weeks post-BNCT, concurrent with the clinical manifestation of radiation erythema. The location of the erythematous visible and infrared regions is consistent with the 3D dosimetry calculations.
Thursday, April 11, 2013
Spectron IR Medical Infrared Imaging System
FDA 510(k) Indications for Use
FDA 510(k) #KO32471
Spectron IR is exclusive manufacturer of the TyTron C-500 IR Clinical Infrared Imaging System. The following is the FDA Premarket Notification 510(k) which is applicable to this system.
Indications for use: The TyTron C-500 IR Clinical Infrared Imaging System is intended for adjunctive diagnostic screening for the detection of breast cancer and other uses such as: peripheral vascular disease, neuromusculoskeletal disorders, extracranial cerebral and facial vascular disease, thyroid gland abnormalities, and various other neoplastic, metabolic and inflammatory conditions. Use of the TyTron C-500 is not intended to be a sole diagnostic procedure for these diseases and conditions.
Monday, April 8, 2013
Cancer Detect Prev.
2009;32(5-6):431-6. Epub 2009 Feb 20.
Specific thermographic changes during Walker 256 carcinoma development: differential infrared imaging of tumor inflammation and haematoma.
Poljak-Blazi M, Kolaric D, Jaganjac M, Zarkovic K, Skala K, Zarkovic N. Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia.
BACKGROUND: Infrared imaging measures spatial variations in the skin temperature aiming to determine pathological processes; hence possible use of this non-invasive analytical method in cancer detection is emerging.
METHODS: Infrared thermal imaging was used to detect changes in rat skin surface temperature
associated with experimental cancer development (Walker 256 carcinoma), inflammation (upon s.c. Sephadex injection) and haematoma (provoked by s.c. blood coagulate injection). Infrared camera with a geometric resolution of 76,800 pixels, spectral range of 8-14 microns and the minimal detectable temperature resolution of 0.07 degrees C with spatial resolution of 0.48 mm at measuring distance of 30 cm was used to obtain computerized thermal scans.
RESULTS: The raise of peripheral temperature was observed after induction of local inflammation or haematoma. Opposite to that, transient decrease of the skin surface temperature was observed after tumor
transplantation. Progressive growth of tumor was associated with the raise of the skin surface temperature from the 10th day after tumor inoculation, when the tumors developed supportive neoangiogenic blood supply, as verified by histology.
CONCLUSION: While the raise of peripheral temperature in advanced tumor was caused by neoangiogenesis, the reduction in skin surface temperature in an early period after tumor cell inoculation indicated a decay of transplanted tumor cells due to the immune response and the lack of blood supply. Thus, infrared thermal imaging may have considerable value in evaluation of the tumor development and
discrimination of cancer from inflammation and haematoma.
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