Infrared thermography: a rapid, portable, and accurate technique to detect experimental pneumothorax.

Infrared thermography: a rapid, portable, and accurate technique to detect experimental pneumothorax.
Rich PB, Dulabon GR, Douillet CD, Listwa TM, Robinson WP, Zarzaur BL, Pearlstein R, Katz LM.

Source
Department of Surgery, School of Medicine, Medical Wing D Room 186, CB #7228, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7228 USA.
prich@med.unc.edu

Abstract
RATIONALE AND OBJECTIVE:
Pneumothorax (Ptx) is a life-threatening complication that can result from trauma, mechanical ventilation, and invasive procedures. Infrared thermography (IRT), a compact and portable technology, has become highly sensitive. We hypothesized that IRT could detect Ptx by identifying associated changes in skin temperature.

MATERIALS AND METHODS:
Bilateral nonpenetrating chest incisions or needle punctures were performed in 21 anesthetized rats. Rats were then randomized to no, bilateral, left, or right Ptx by either open (n = 16) or closed percutaneous (n = 5) puncture through selected pleurae. Real-time thermographic images and surface temperature data were acquired with a noncooled infrared camera.

RESULTS:
In all cases, blinded observers correctly identified each Ptx with real-time grayscale image analysis. When compared to either the ipsilateral baseline or an abdominal reference, experimental Ptx produced a significantly greater decrease in surface temperature when compared to non-Ptx control.

CONCLUSIONS:
These results demonstrate that portable infrared imaging can rapidly and accurately detect changes in thoracic surface temperature associated with experimental pneumothorax.

Thermographic assessment of stellate ganglion block effectiveness during cardiosurgical procedures. 

Rogowski J, Mroziński P, Jagielak D, Lango R, Narkiewicz M, Wujtewicz M. Source Department of Cardiosurgery, Institute of Cardiology, Medical University, ul. Debinki 7, Gdańsk. janrog@amg.gda.pl

Abstract
The study present thermographic assessment of the effectiveness of temporary stellate blockade performed during cardiosurgical procedures. The assumption behind this method was the increase in the temperature of upper extremity on the side of blockade, due to the broadening of arterial bed.

MATERIAL AND METHOD: The study was conducted on a group of 30 patients (21 men and 9 women) operated due to coronary disease involving three vessels. Mean age of the patients was 53 years. After introduction of anaesthesia blockade were performed with 2 ml 2% lignocainum and 8 ml 0.5% bupivacaine solution using peratracheal approach. Blockade effectiveness was assessed on the basis of images obtained in thermovisual camera, comparing the temperatures of upper extremity before and within 15 minutes after performing the blockade. Free blood outflow from radial artery, its diameter and length were also evaluated. The results obtained were subject to statistical analysis.

RESULTS: Twenty-three patients (76.6%) displayed the increase in the temperature of upper extremity by 1-3 degrees C. Free blood outflow from radial artery was greater in this group than in the remaining patients.

CONCLUSIONS: Thermography is a useful method for the assessment of stellate blockade effectiveness. Effective blockade results in the increased blood flow in radial artery.

Skin temperature measured by infrared thermography after ultrasound-guided blockade of the sciatic nerve

Skin temperature measured by infrared thermography after ultrasound-guided blockade of the sciatic nerve.

van Haren FG, Kadic L, Driessen JJ.

Source
Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Abstract
BACKGROUND:
In the present study, we assessed the relationship between subgluteal sciatic nerve blocking and skin temperature by infrared thermography in the lower extremity. We hypothesized that blocking the sciatic nerve will lead to an increase in temperature, and that this will correlate with existing sensory block tests.
METHODS:
We studied 18 healthy individuals undergoing orthopaedic surgery of the foot under ultrasound-guided subgluteal blockade of the sciatic nerve with 30 ml ropivacaine 7.5 mg/ml. Skin temperature was measured on the toes, the dorsal and plantar side of the foot, the malleoli, and the lateral side of the lower leg, just before sciatic nerve blockade and at 10-min intervals thereafter.
RESULTS:
Baseline skin temperatures showed a significant distal-to-proximal gradient. After sciatic block, temperatures on the blocked side increased significantly in the toes and foot. When comparing pinprick to skin temperature in a receiver operating curve, there was an AUC of 85.9% (95% confidence interval = 83.7-88.2%, P < 0.001). The medial malleolus (not being innervated by the sciatic nerve) showed no significant difference to the lateral.
CONCLUSIONS:
After sciatic nerve block, temperatures of the foot increased significantly. There was a good correlation between pinprick testing and infrared temperature measurement. This makes infrared skin temperature measuring a good test in determining block success when sensory testing is impossible.

© 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Thermography and colour duplex ultrasound assessments of arterio-venous fistula function in renal patients.

Thermography and colour duplex ultrasound assessments of arterio-venous fistula function in renal patients. 

Allen J, Oates CP, Chishti AD, Ahmed IA, Talbot D, Murray A. Source Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK. john.allen@nuth.nhs.uk

Abstract 

Vascular and clinical assessments of arterio-venous fistula (AVF) function and access are important in patients undergoing or preparing to undergo renal dialysis. Objective assessment techniques include colour duplex ultrasound and more recently medical infrared thermography. Ideally, these should help assess problems relating to fistula failure or to vascular steal from the hand which can result from excessive fistula blood flow. The clinical value of thermography, as yet, has not been assessed for this patient group. The aims of this study were therefore to investigate the relationships between thermography skin temperature measurement and (a) quantitative ultrasound measurement of AVF blood flow, and (b) qualitative clinical assessment of vascular steal from the hands. Fifteen adult patients underwent thermal imaging of the upper limbs, colour duplex ultrasound to derive AVF blood flow from brachial artery blood flow measurements, and a clinical evaluation for vascular steal. Temperature measurements were extracted from the thermograms, including bilateral arm and hand (Fistula -- Non-Fistula) differences, for comparison with derived AVF blood flow and steal grading. Derived AVF blood flow ranged from 30 to 1,950 ml min(-1), with a mean rate close to one litre per minute. Thermography detected the warmer superficial veins in proximity to the patent fistulas, with bilateral differences in fistula region skin temperature correlated with derived AVF blood flow (using maximum temperature measurements the correlation was +0.71 [p < 0.01]; and using mean temperature measurements the correlation was +0.56 [p < 0.05]). When thermography measurements were compared with the clinical assessment of steal the mean hand temperature differences separated steal from non-steal patients with an accuracy of greater than 90%. In summary, we have now demonstrated the potential clinical value of medical infrared thermography for assessing AVF function in renal patients.

Peripheral vascular reactions to smoking--profound vasoconstriction by atherosclerosis.

Diabetes Res Clin Pract 1998 Oct;42(1):29-34
Peripheral vascular reactions to smoking--profound vasoconstriction by atherosclerosis.

Fushimi H, Kubo M, Inoue T, Yamada Y, Matsuyama Y, Kameyama M; Department
of Medicine, Sumitomo Hospital, Osaka, Japan.

Analyses of direct effects of smoking on peripheral arteries were done using thermography, blood fluorometry and echography on 97 habitual smoker diabetics without triopathy. There were found to be four types of thermographic changes following smoking, which varied according to the degree of atherosclerosis of the artery. The smoking-stimulated thermographic pattern in the control group of healthy volunteers was a small wavy pattern, fluctuating along the base line every few minutes within a temperature range of 1.0-1.5 degrees C (N type). In diabetics, four types of thermographic patterns were produced: normal (N) type as control, increasing (I) type (increasing in skin temperature), decreasing (D) type (decreasing in temperature), and F type (no changes in temperature). The most significant finding was the decreasing pattern which closely connected to clinical and echographic aspects of macroangiopathic changes. The increasing type was characterized by a paradoxical increase in temperature after smoking in order diabetics with good blood glucose control and who were less atherosclerotic. Blood flow was correlated to the skin temperature at the base state and changes after smoking. Moreover, blood flow changes measured by fluorometry suggest that vasoconstriction or vasodilatation following smoking took place. These results suggest that
this smoking test might be a good tool for diagnosing for the degree of atherosclerosis and for its
following up.

Is DVT Excluded by Normal Thermal Imaging - An Outcome Study of 700 Cases.

Deep Vein Thrombosis: Proceedings - 19th International Conference - IEEE/EMBS Oct. 30-Nov. 2, 1997 Chicago, IL
Is DVT Excluded by Normal Thermal Imaging - An Outcome Study of 700 Cases.

Harding, J. Richard; Barnes, Kathryn M.; Department of Clinical Radiology, St Woolos Hospital, Glan Hafren NHS Trust, Newport, Gwent, U.K.

In view of the many advantages compared with venography or Doppler ultrasound, and the ability to avoid the necessity for over one third of these investigations, thermal imaging should be considered the initial investigation of choice in clinically suspected DVT, proceeding to venography or Doppler ultrasound only when thermal imaging is positive. There are risks and disadvantages to the most commonly utilised conventional tests for DVT, over one third of which examinations can be avoided by performing thermal imaging as the initial investigation, which excludes DVT when normal. This outcome study followed up patients with clinically suspected DVT who were not further investigated or treated following normal thermal imaging, and showed that no patients developed PE (pulmonary embolism) following normal thermography with no further investigation for DVT and withholding of anticoagulant therapy.

Thermography and laser-Doppler flowmetry for monitoring changes in finger skin blood flow upon cigarette smoking.

Clin Physiol 1991 Mar;11(2):135-41
Thermography and laser-Doppler flowmetry for monitoring changes in finger skin blood flow upon cigarette smoking.
Bornmyr S, Svensson H.; Department of Clinical Physiology, Allmanna Sjukhuset, Malmo, Sweden.

Haemodynamic changes after smoking two 1.1 mg nicotine cigarettes were monitored in 24 smokers on two different occasions. Smoking caused an increase in heart rate and arterial blood pressure, whereas finger temperature as measured by thermography and finger skin blood flow as measured by laser-Doppler flowmetry (LDF) decreased. Lowest values were seen within 15 min by LDF, and after 30 min by thermography. Changes in the two methods correlated closely, however, when maximum responses during a 45-min period after smoking were compared. The wider distribution of LDF values would seem to be due to the small measuring volume which is susceptible to differences in vascular anatomy and reactivity. In both methods, responses showed a high degree of reproducibility.

Beating Breast Cancer
William Hobbins, MD, FABS, DABCT, FIACT William Amalu, DC, DABCT, DIACT,
FIACT

This year, over 192,000 women will be diagnosed with breast cancer in the US and 1.2 million worldwide (Source: American Cancer Society and WHO). As shocking as these numbers are, even worse is the number of cancers that won’t be detected until it’s too late. The consensus among
experts is that early detection holds the key to survival. Although this is true, detection is not occurring early enough. Even though women are advised to begin having mammograms at 40, what they don’t know is that by the time most cancers are detected they have been growing for 10 years, and that 20% of all cancers can’t be seen by a mammogram. It is because of these factors, and others, that the number of women who die from this disease has gone relatively unchanged in the past 40 years.

A change from sole dependence upon procedures that only provide detection of existing cancers to technologies that reflect the early cancerous process itself would provide women with true screening.




If a significant change in breast cancer mortality is to be realized, we have to rethink what screening tests truly are. Are we currently providing “screening” or “detection”? A critical look at what we are
providing women must be made.  If there were a method of very early detection, a procedure that would act as an early warning system, women would have the fighting chance they need to win this battle. What is needed is a biological risk marker. A biological risk marker would be able to turn these grave statistics around, as aggressive tissues would be detected before they were able to
invade the rest of the body. Women now have access to a unique technology that can give them this early warning; a procedure called Breast Thermography.

Breast thermography is an imaging technology that uses advanced computerized infrared camera systems to detect heat patterns in the breast. When a cancer is forming it develops its own blood supply in order to feed its accelerated growth (a process known as malignant angiogenesis). Even
more important, precancerous tissues can start this process well in advance of the cells becoming malignant. This increased Research has determined that the single greatest risk factor for the future development of breast cancer is lifetime exposure of the breasts to estrogen. In which case,  controlling the influence of estrogen on the breasts would be the single greatest method of primary breast cancer prevention. Studies show that breast thermography has the ability to warn a woman that a cancer may be forming up to 10 years before any other test can detect it. blood supply causes an abnormal heat pattern in the breast. Thermography can detect this abnormal heat pattern by scanning the breasts with a specialized infrared camera and analyzing the information using sophisticated computer programs under the guidance of a doctor who is board certified in the procedure. These abnormal heat patterns are among the earliest known signs of a forming cancer.

Studies show that this technology has the ability to warn a woman that a cancer may be forming up to 10 years before any other test can detect it.

An unprecedented level of early detection can be realized when thermography is added to a
woman’s regular breast health care. It has been found that an abnormal thermographic image is the single most important sign of high risk for developing breast cancer, 10 times more significant than a first order family history of the disease.  This gives breast thermography not only the ability to detect cancer at its earliest and most treatable stage, but to also act as a biological marker warning a woman about her own unique level of future risk for breast cancer.

Women who undergo the test find it to be fairly uneventful, since the procedure uses no radiation or contact with the breasts. Women with dense breasts, implants, and women who are pregnant or nursing can be imaged without any harm or reduction in the accuracy of the test. Normal images, show evenly cool inactive breasts (dark colors represent cold areas). Abnormal images, as seen on the right, show highly active blood vessels giving off heat in one breast. Since the procedure does not pose any harm to the patient, women who are at higher risk can be monitored closely without adverse effects on their health.

Research has determined that the single greatest risk factor for the future development of breast cancer is lifetime exposure of the breasts to estrogen. In which case, controlling the influence of estrogen on the breasts would be the single greatest method of primary breast cancer prevention.

Another benefit of this technology is its role in primary breast cancer prevention. Breast  thermography has the added ability to observe the influence of hormones on the breasts.  When hormone activity in the breast is dominated by estrogen, a specific type of infrared image is produced; thus, warning the patient of this condition. Once this is identified, a woman can take a significant pro-active role in prevention. With this information in hand, many doctors start their patients on a regimen of progesterone cream applied directly to the breasts. The progesterone enters
the breast tissue and counteracts the effects of estrogen. Using follow up infrared imaging, the treatment can be monitored and changed if necessary to meet the needs of each woman’s own unique physiology. Once the hormone balance has been restored to the breasts, a woman’s overall breast cancer risk is greatly reduced. The lifesaving implication of having this knowledge is incredible.

With the incidence of breast cancer steadily rising in women under 40, an effort to provide some form of accurate screening test is needed in this age group. Very early detection is especially important since breast cancers in younger women are commonly more aggressive resulting in lower survival rates. Current screening procedures have proven to be inaccurate in women in this age group due to breast tissue density and other factors. These issues, however, do not affect thermography. With this technology, women under 40 now have a safe and objective screening method that they can add to their regular breast health checkups.

Breast thermography is a high-tech non-invasive screening procedure designed to be used by women of all ages. The technology has been thoroughly researched for over 30 years and is FDA approved for use in breast cancer screening. Its unique ability to play a significant role in prevention is an impressive added benefit. Unfortunately, at this time there are too few qualified clinical thermography centers worldwide. However, with the increasing demand for breast thermography, recognized educational organizations, such as the International Academy of Clinical Thermology, are actively seeking personnel for training as certified technicians. It is their goal to provide women with greater access to this lifesaving technology.

Currently, no single screening procedure can detect 100% of all breast cancers. Thermography is designed to be used with mammography and not as a replacement. Studies show that when thermography is added to a woman’s regular breast health checkups (physical examination + mammography + thermography), 95% of all early stage cancers will be detected. This would give the vast majority of women who are diagnosed with this disease the reality of returning to a normal healthy life.

Should we continue to concentrate our efforts on procedures that can only detect an existing cancer, or should we be focusing on true screening methods that can warn of a pending problem far in advance? The number of women who die from this disease will continue relatively unchanged if nothing is done to provide them with a true early warning system. Breast thermography has the unique ability to warn most women far enough in advance to give them a fighting chance. Combined
with its ability to play a role in primary prevention, the lifesaving implications are incredible. The addition of this technology to every woman’s breast health care will make the greatest impact
on breast cancer mortality. With breast thermography, women of all ages are given hope and a true early detection edge in the battle against breast cancer.

About the authors-

William Hobbins, MD, a Fellow of the American Board of Surgeons and a board certified clinical thermologist, has been performing thermographic breast imaging for over 35 years. As an internationally recognized authority in this field, he has sat on multiple medical and thermographic boards, authored numerous articles, and has contributed a significant amount of research to the medical database using this technology. He currently practices in Madison Wisconsin and can be contacted at 608-273-4274.

William Amalu, DC, a Fellow of the International Academy of Clinical Thermology and a board certified clinical thermologist, has utilized thermography in practice for over 14 years. He is currently the President of the International Academy of Clinical Thermology and practices in Redwood City California. He can be contacted at 650-361-8908
www.breastthermography.com
http://www.stocktonfp.com/Articles/Beating%20Breast%20Cancer.pdf