First application of dynamic infrared imaging in boron neutron capture therapy for cutaneous malignant melanoma.

First application of dynamic infrared imaging in boron neutron capture therapy for cutaneous malignant melanoma.

Santa Cruz GA, González SJ, Bertotti J, Marín J.

Source

Departamento de Instrumentación y Control, Comisión Nacional de Energía Atómica, Avenida del Libertador 8250, 1429 Buenos Aires, Argentina. santacr@cnea.gov.ar

Abstract

PURPOSE:

The purpose of this study is to assess the potential of dynamic infrared imaging (DIRI) as a functional, noninvasive technique for evaluating the skin acute toxicity and tumor control within the framework of the Argentine boron neutron capture therapy (BNCT) program for cutaneous malignant melanoma.

METHODS:

Two patients enrolled in the Argentine phase I/II BNCT clinical trial for cutaneous malignant melanoma were studied with DIRI. An uncooled infrared camera, providing a video output signal, was employed to register the temperature evolution of the normal skin and tumor regions in patients subjected to a mild local cooling (cold stimulus). In order to study the spatial correlation between dose and acute skin reactions, three-dimensional representations of the superficial dose delivered to skin were constructed and cameralike projections of the dose distribution were coregistered with visible and infrared images.

RESULTS:

The main erythematous reaction was observed clinically between the second and fifth week post-BNCT. Concurrently, with its clinical onset, a reactive increase above the basal skin temperature was observed with DIRI in the third week post-BNCT within regions that received therapeutic doses. Melanoma nodules appeared as highly localized hyperthermic regions. 2 min after stimulus, these regions reached a temperature plateau and increased in size. Temperature differences with respect to normal skin up to 10 degrees C were observed in the larger nodules.

CONCLUSIONS:

Preliminary results suggest that DIRI, enhanced by the application of cold stimuli, may provide useful functional information associated with the metabolism and vasculature of tumors and inflammatory processes related to radiation-induced changes in the skin as well. These capabilities are aimed at complementing the clinical observations and standard imaging techniques, such as CT and Doppler ultrasound.

Analysis of transient thermal images to distinguish melanoma from dysplastic nevi

Analysis of transient thermal images to distinguish melanoma from dysplastic nevi

Muge Pirtini Çetingül ; Hasan E. Çetingül ; Cila Herman

Abstract

We have recently developed a dynamic infrared (IR) imaging system that provides accurate measurements of transient thermal response of the skin surface for characterizing lesions. Our hypothesis was that malignant pigmented lesions with increased proliferative potential generate quantifiable amounts of heat and possess an ability to reheat more quickly than the surrounding normal skin, thereby creating a marker of melanoma lesions vs. non-proliferative nevi. In our previous studies, we demonstrated that the visualization and measurement of the transient thermal response of the skin to a cooling excitation can aid the identification of skin lesions of different origin. This capability of distinguishing benign from malignant pigmented lesions is expected to improve the specificity and sensitivity for melanoma as well as other skin cancers, while decreasing the number of unnecessary biopsies. In this work, in order to quantify the transient thermal response with high accuracy, we present a processing framework on multimodal images, which includes a feature point (landmark) detection module, an IR image registration module that uses the resulting landmarks to correct involuntary body/limb motion and an interactive white-light image segmentation module to delineate the contours of the lesions. The proposed method is tested in a pilot patient study in which all the patients possess a pigmented lesion with a clinical indication for biopsy. After scanning, biopsying, and grading the lesions for malignant potential, we observe that the results of our approach match well with the biopsy results.

A Novel Method of Measuring Tear Evaporation Rates using Infrared Thermography

A Novel Method of Measuring Tear Evaporation Rates using Infrared Thermography

Andrea Petznick¹, Samantha Sze Yee Lee¹, Jen Hong Tan², U. Rajendra Acharya^2,3,4, Eddie Ng⁵, Louis Tong^1,6,7,8

¹Singapore Eye Research Institute, Singapore

²School of Engineering, Ngee Ann Polytechnic, Singapore

³SIM University, Singapore

⁴Singapore Institute of Technology – University of Glasgow, Singapore

⁵School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore

⁶National Eye Centre, Singapore

⁷Duke-NUS Graduate Medical School, Singapore

⁸Yoon Loo Lin School of Medicine, National University of Singapore

PURPOSE: Dry eye is a very common medical problem and meibomian gland dysfunction (MGD) may be an aggravating factor. There is no single reliable diagnostic tool to determine the presence and severity of dry eye and MGD. The measurement of dynamic tear evaporation rates would allow for a more objective diagnosis. In this study, we present a novel non-invasive method of measuring tear evaporation rates using infrared thermography that is reliable and able to detect changes after heat therapy.

METHODS: Infrared thermographic sequential images of ocular surface temperature were recorded from healthy participants (mean age ± SD: 24±7 years) while remaining in a consulting room with a temperature of 22.08±0.77°C and humidity of 63.82±0.02%. 1) Repeatability of the equipment was tested by taking 2 measurements 20 min apart (n=16). 2) Measurements were taken before and 60 min after 5-min heated eye mask wear (Eyegiene^®, US) (n=10) to test for changes in ocular surface temperature and tear evaporation. Tear evaporation rates were calculated based on ocular surface temperature profiles and controlled for body and room temperature as well as room humidity using principles of thermodynamics. Statistical comparisons were performed using paired t-test with p<0.05.

RESULTS: 1) There were significant correlations between the first and second measurements of ocular surface temperature (r=0.94) and tear evaporation rates (r=0.98) (p<0.01). The coefficients of repeatability were 0.42˚C for ocular surface temperature and 6.78 Wm^-2 for tear evaporation rates. 2) Ocular surface temperature before heat therapy was 33.66±0.53˚C which significantly decreased to 32.50±0.97˚C after heat application (p<0.01). Tear evaporation rates significantly increased from 65.64±12.51 to 78.72±21.53 Wm^-2 following heat treatment (p<0.01). 

CONCLUSIONS: We established that ocular thermography has a good repeatability in measuring ocular surface temperatures and tear evaporation rates under constant conditions and may therefore present a valuable tool for diagnosing dry eye and MGD. Findings also suggest a drop in ocular surface temperature and an increase in tear evaporation 60 min after heating, but it is possible that vasodilation in ocular tissues may have affected calculations of tear evaporation rates after heating.

Impacts on the skin temperature by the different distances of moxibustion: discussion on the safe distance of moxibusiton.

Impacts on the skin temperature by the different distances of moxibustion: discussion on the safe distance of moxibusiton.
Xu PC, Lee TL, Cui SL.

Source Acupuncture Clinic, Rehabilitation Centre of National University Hospital, Singapore 119074, Singapore. pecxu@163.com

Abstract
OBJECTIVE: To observe the impacts of the different distances of moxibustion on local skin temperature and provide a safy distance of moxibustion.

METHODS: Three healthy adult volunteers were included. The pure moxa stick (without other herbs mixed together) was used. The moxa-stick moxibustion and the mild moxibustion (with moxa box) were applied to Zusanli (ST 36) on the right side and Guanyuan (CV 4) respectively. The distance from moxibustion to the local skin was 2 cm, 3 cm and 4 cm separately. The moxibustion time was limited by 3 cm stick burned out. The infrared thermography was adopted to record and store thermal images and made the systematic analysis. The same trial was repeated on the second day. The means of the skin temperature measured at each acupoint each time was taken as the results for the analysis.

RESULTS: (1) Moxibustion with moxa box at Guanyuan (CV 4): at the distance of 4 cm, the local skin temperature at over 44 degrees C [(44.1 +/- 1.3)-(46.7 +/- 1.5) degrees C)] lasted 7 min; at the distance of 3 cm, the local skin temperature at over 44 degrees C [(44.1 +/- 1.3)-(49.3 +/- 2.0) degrees C] lasted about 10 min and that at over 49 degrees C [(49.0 +/- 2.1)-(49.3 +/- 2.0) degrees C)] lasted 2 min; at the distance of 2 cm, the observation could not be followed due to local burning pain. (2) Moxa-stick moxibustion at Zusanli (ST 36): at the distance of 4 cm, the skin temperature was ranged from (40.0 +/- 2.0) degrees C to (44.9 +/- 2.3) degrees C; at the distance of 3 cm, in 1 min of moxibustion, the skin temperature increased over 44 degrees C, sustaining in the range from (45.9 +/- 3.0) degrees C to (47.8 +/- 2.0) degrees C; at the distance of 2 cm, the observation could not be followed due to local burning pain.

CONCLUSION: In moxibustion, the closer the moxa stick to the skin is, the higher the local skin temperature is. No matter with stick moxibustion or box moxibustion, the distance of moxa stick to the skin should be in the range from 3 to 4 cm.

Peripheral facial paralysis aided by infrared thermography.

Peripheral facial paralysis aided by infrared thermography.
We have carried out clinical observations on 34 patients with peripheral facial paralysis treated by
acupuncture therapy prescribed according to selection of treatment regimen on the basis of facial
thermogram and temperature. A comparison was made with a control group of 97 patients who received conventional acupuncture therapy only. It was found that: (1) The cure rate in the group of selecting acupoints by thermogram (hereinafter referred to as the thermography--aided treatment group) was 67.65%, with a marked improvement rate of 26.40%; while the cure rate of the conventional acupuncture treatment group (hereinafter called the conventional treatment group) was 46.39%, the marked improvement rate being 29.90%, indicating a significant difference in therapeutic efficacy between the two groups (P less than 0.02). (2) The average duration of acupuncture therapy for the thermography aided treatment group was 6.02 weeks, whereas that for the conventional treatment group, 24 weeks. There was also a significant difference between the two groups (p less than 0.01). (3) During the entire therapeutic course, 25.2 sessions of treatment were given on the average in the thermography--aided treatment group, and 78.8 sessions in the conventional treatment group, showing a very significant difference (P less than 0.001). The present thermography--aided method exhibits advantages over the conventional one in enhancing the cure rate and shortening the duration of treatment, which is worthy to be popularized in clinical practice. It is also of certain significance in standardization and scientification of acupuncture therapy.
Zhang D; Wei Z; Wen B; Gao H; Peng Y; Wang F.

Facial thermography is a sensitive and specific method for assessing food challenge outcome.

Facial thermography is a sensitive and specific method for assessing food challenge outcome.
Clark AT, Mangat JS, Tay SS, King Y, Monk CJ, White PA, Ewan PW.
Department of Allergy, Cambridge University Hospitals NHS Trust, Addenbrookes Hospital, Cambridge, UK.

BACKGROUND: Oral challenge is widely used for diagnosing food allergy but variable interpretation of subjective symptoms may cause error. Facial thermography was evaluated as a novel, objective and sensitive indicator of challenge outcome.

METHODS: A total of 24 children with a history of egg allergy underwent oral challenge, which were scored positive when objective symptoms occurred or negative after all doses were consumed without reaction. Facial temperatures were recorded at baseline and 10-min intervals. The difference between mean and baseline temperature (DeltaT), maximum DeltaT during challenge (DeltaT(max)) and area under curve of DeltaT against time (DeltaTAUC) were calculated for predefined nasal, oral and forehead areas, and related to objective challenge outcome.

RESULTS: There were 13 positive and 11 negative challenges. Median nasal DeltaTAUC and DeltaT(max) were greater in positive compared with negative challenges (231- and 5-fold, respectively; P < 0.05). In positive challenges, nasal temperatures showed an early transient rise at 20 min, preceding objective symptoms at median 67 min. There was a sustained temperature increase from 60 min, which was reduced by antihistamines. A cut-off for nasal DeltaT(max) of 0.8 degrees C occurring within 20 min of the start of the challenge predicted outcome with 91% sensitivity (positive predictive value [PPV] 100%) and 100% specificity (negative predictive value [NPV] 93%). Subjective symptoms occurred in four of 13 positive and three of 11 negative challenges.

CONCLUSIONS: Facial thermography consistently detects a significant early rise in nasal temperature during positive compared with negative food challenges, which is evident before objective symptoms occur. Thermography may therefore provide a sensitive method to determine outcome of food challenges and investigate the pathophysiology of food allergic reactions.

Facial skin surface temperature changes during a "concealed information" test.

Facial skin surface temperature changes during a "concealed information" test.
Department of Defense Polygraph Institute, 7540 Pickens Ave., Fort Jackson, SC, 29207, USA.

When individuals who commit a crime are questioned, they often show involuntary physiological
responses to remembered details of that crime. This phenomenon is the basis for the concealed
information test, in which rarely occurring crime-related details are embedded in a series of more
frequently occurring crime-irrelevant items while respiratory, cardiovascular, and electrodermal responses are recorded. Two experiments were completed to investigate the feasibility of using facial skin surface temperature (SST) measures recorded using high definition thermographic images as the physiological measure during a concealed information test. ... During both experiments, there were significant facial SST differences between deceptive and nondeceptive participants early in the analysis interval. In the second experiment, hemifacial (i.e., "half-face" divided along the longitudinal axis) effects were combined with the bilateral responses to correctly classify 91.7% of participants. These results suggest that thermal image analysis can be effective in discriminating deceptive and nondeceptive individuals during a concealed information test.

Diagnosis, treatment and prevention of autism via meridian theory.

Diagnosis, treatment and prevention of autism via meridian theory. 
Lo SY.

Source Quantum Health Research Institute, 3788 Oakdale Ave, Pasadena, CA 91107, USA. ideaclinic@yahoo.com

Abstract
A twelve-week pilot study was conducted on 11 male children, aged five to 19 years, who had ASD (autistic symptom disorder) of varying degrees of severity. These eleven subjects were each examined three times in the 12-week period: at the first week, 6th week, and 12th week. During each examination, two sets of full-body thermographs were taken of each child, before and fifteen minutes after drinking a solution of stable water clusters with a double helix configuration. This solution of stable water clusters is called double helix water (DHW). In the before thermographs, a consistent thermal pattern of six hot regions of body surface temperature were identified. They are: left and right upper forehead region of the face; left and right area in front of the center of the ear; left and right area of the inner extreme point of the eye; left and right collarbone region; left and right side neck region; and left and right armpit region. These areas may be interpreted as regions surrounding various acupoints along the GB, BL, ST, SI, SJ meridians. These meridians are yang meridians that on one end reach the head, and hence have branches reaching into the brain, and on the other end reach to the gastrointestinal tract and urinary bladder system. Thus, they can be considered to explain the major clinical symptoms of ASD. These thermal patterns, if confirmed in a larger clinical study, may lead to a new way to diagnose ASD, and to test the effectiveness of any treatment. When such a thermal pattern is discovered early, say around the age of 18 months, preventive action can be initiated before observation of any behavior disorder. We simultaneously studied the healing effect of stable water clusters with double helix configuration (DHW) on these subjects. The quantitative reduction of maximum temperature at these six regions was calculated. A consistent reduction was noted and suggests a positive healing effect taking place within a very short time period (fifteen minutes), and lasting over a long time period (12 weeks). Quantitative evaluation by the parents over the 12-week period showed that eight out of 11 children had physiological and behavioral improvement. Our findings with these small numbers suggest a reliable method of early diagnosis/detection and also an effective treatment of ASD. We therefore conclude that a study of larger numbers of children with ASD should be conducted.

Contemporary applications of infrared imaging in medical diagnostics

Contemporary applications of infrared imaging in medical diagnostics
Mikulska D.

Katedra i Klinika Chorób Skórnych i Wenerycznych Pomorskiej Akademii Medycznej al. Powstanców Wlkp. 72, 70-111 Szczecin.

INTRODUCTION: Thermal imaging is a non-contact, non-invasive diagnostic method
for study human body temperature. Therefore infra red thermal imaging finds
increasing application in clinical medicine.

PURPOSE: The aim of this paper was to
present and discuss the history and applications of thermal imaging in medicine.

MATERIAL AND METHODS: The literature dealing with the history and applications
of thermal imaging in medicine has been reviewed.

RESULTS: Medical thermography was born in 1957 when a surgeon, Dr. R. Lawson discovered that his breast cancer patients had higher skin temperature over the cancer area. Since the 1970's thermography has been used in many areas of medicine. Early problems such as low detector sensitivity, but most significantly, poor training of thermography technicians was the source of error in thermography and retarded the acceptance of this technique until 1990. Since that time, thermographic equipment has evolved significantly. Modern thermal imaging systems comprise
technically advanced thermal cameras coupled to computers with sophisticated software solutions. The recorded images are now of good quality and may be further processed to obtain reliable information. Thermography can be applied as a diagnostic tool in oncology, allergic diseases, angiology, plastic surgery, rheumatology, and elsewhere. Contemporary thermal imaging must be performed according to certain principles aimed at reliability and reproducibility of results.

CONCLUSIONS: 1. Thermography is a safe, accurate and, most importantly, a noninvasive
diagnostic method in clinical medicine. 2. Ignoring any of the principles worked out by the European Association of Thermology leaves thermography open to error and thus reduces acceptance of this technique in medical diagnostics.

Evaluation of low level laser and interferential current in the therapy of complex regional pain syndrome by infrared thermographic camera.

Evaluation of low level laser and interferential current in the therapy of complex regional pain syndrome by infrared thermographic camera. 
[Article in Serbian] Kocić M, Lazović M, Dimitrijević I, Mancić D, Stanković A. Source Klinicki centar Nis, Klinika za fizikalnu medicinu, rehabilitaciju i protetiku, Nis, Srbija. kocicm60@gmail.com

Abstract
BACKGROUND/AIM; Complex regional pain syndrom type I (CRPS I) is characterised by continuous regional pain, disproportional according to duration and intensity and to the sort of trauma or other lesion it was caused by. The aim of the study was to evaluate and compare, by using thermovison, the effects of low level laser therapy and therapy with interferential current in treatment of CRPS I.

METHODS: The prospective randomized controlled clinical study included 45 patients with unilateral CRPS 1, after a fracture of the distal end of the radius, of the tibia and/or the fibula, treated in the Clinical Centre in Nis from 2004 to 2007. The group A consisted of 20 patients treated by low level laser therapy and kinesy-therapy, while the patients in the group B (n = 25) were treated by interferential current and kinesy-therapy. The regions of interest were filmed by a thermovision camera on both sides, before and after the 20 therapeutic procedures had been applied. Afterwards, the quantitative analysis and the comparing of thermograms taken before and after the applied therapy were performed.

RESULTS: There was statistically significant decrease of the mean maximum temperature difference between the injured and the contralateral extremity after the therapy in comparison to the status before the therapy, with the patients of the group A (p < 0.001) as well as those of the group B (p < 0.001). The decrease was statistically significantly higher in the group A than in the group B (p < 0.05).

CONCLUSIONS: By the use of the infrared thermovision we showed that in the treatment of CRPS I both physical medicine methods were effective, but the effectiveness of laser therapy was statistically significantly higher compared to that of the interferential current therapy

Infrared thermography as an access pathway for individuals with severe motor impairments.

Infrared thermography as an access pathway for individuals with severe motor impairments.
Memarian N, Venetsanopoulos AN, Chau T. Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.

BACKGROUND: People with severe motor impairments often require an alternative access pathway, such as a binary switch, to communicate and to interact with their environment. A wide range of access pathways have been developed from simple mechanical switches to sophisticated physiological ones. In this manuscript we report the inaugural investigation of infrared thermography as a non-invasive and non-contact access pathway by which individuals with disabilities can interact and perhaps eventually communicate.

METHODS: Our method exploits the local temperature changes associated with mouth opening/closing to enable a highly sensitive and specific binary switch. Ten participants (two with severe disabilities) provided examples of mouth opening and closing. Thermographic videos of each participant were recorded with an infrared thermal camera and processed using a computerized algorithm. The algorithm detected a mouth open-close pattern using a combination of adaptive thermal intensity filtering, motion tracking and morphological analysis.

RESULTS: High detection sensitivity and low error rate were achieved for the majority of the participants (mean sensitivity of all participants: 88.5% +/- 11.3; mean specificity of all participants: 99.4% +/- 0.7). The algorithm performance was robust against participant motion and changes in the background scene.

CONCLUSION: Our findings suggest that further research on the infrared thermographic access pathway is warranted. Flexible camera location, convenience of use and robustness to ambient lighting levels, changes in background scene and extraneous body movements make this a potential new access modality that can be used night or day in unconstrained environments.

The application of temperature measurement of the eyes by digital infrared thermal imaging as a prognostic factor of methylprednisolone pulse therapy for Graves' ophthalmopathy.

The application of temperature measurement of the eyes by digital infrared thermal imaging as a prognostic factor of methylprednisolone pulse therapy for Graves' ophthalmopathy.
Shih SR, Li HY, Hsiao YL, Chang TC.

Source
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Abstract
PURPOSE:
Graves' ophthalmopathy (GO) involves autoimmune process resulting in proptosis, congestion, oedema and diplopia. Werner's NOSPECS classification and clinical activity score (CAS) of GO cannot objectively describe the inflammatory status. Digital infrared thermal imaging (DITI) detects local temperature and may reflect the degree of orbital inflammation. The aim of this study was to evaluate the clinical application of the eye temperature measured by DITI.

METHODS:
Forty-six patients with GO receiving intravenously methylprednisolone pulse therapy (MPT) were included in this study. Local temperatures of the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva, lower eyelid and cornea were measured with DITI before and after MPT. CAS, proptosis, eye movement (EOM) and diplopia were also recorded. Improvement of CAS was defined as at least one point decrease at either side of the eye, which was 0.5 score decrease as to the average of bilateral CAS.

RESULTS:
Local temperatures of the eyes decreased after MPT. The mean value of temperature (MT) of 12 points including the lateral orbit, upper eyelid, inner caruncle, medial conjunctiva, lateral conjunctiva and lower eyelid of both eyes before MPT was 32.65 degrees . The mean change of MT after MPT (DeltaT) was -0.22 degrees. DeltaT significantly negative-correlated with basal MT (correlation coefficient=-0.54, p=0.004). Higher baseline MT and CAS before MPT correlated with higher possibility of improvement of CAS after MPT (p=0.013 and 0.012, respectively). Baseline MT and CAS together correlated with improvement of CAS after MPT
better than baseline CAS alone could do (area under the receiver operating characteristic curve: 82.81% and 66.63%, respectively).

CONCLUSIONS:
Basal temperature of the eyes measured by DITI was an objective indicator of inflammation of GO. Combining CAS and MT could better predict the outcome of MPT than CAS alone.