Lock-in thermal imaging for the early-stage detection of cutaneous melanoma: a feasibility study

Feasibility Study on the Use of Infrared Cameras for Skin Cancer Detection under a Proposed Data Degradation Model

Infrared thermography is considered a useful technique for diagnosing several skin pathologies but it has not been widely adopted mainly due to its high cost. Here, we investigate the feasibility of using low-cost infrared cameras with microbolometer technology for detecting skin cancer. For this purpose, we collected infrared data from volunteer subjects using a high-cost/high-quality infrared camera. We propose a degradation model to assess the use of lower-cost imagers in such a task. The degradation model was validated by mimicking video acquisition with the low-cost cameras, using data originally captured with a medium-cost camera. The outcome of the proposed model was then compared with the infrared video obtained with actual cameras, achieving an average Pearson correlation coefficient of more than 0.9271. Therefore, the model successfully transfers the behavior of cameras with poorer characteristics to videos acquired with higher-quality cameras. Using the proposed model, we simulated the acquisition of patient data with three different lower-cost cameras, namely, Xenics Gobi-640, Opgal Therm-App, and Seek Thermal CompactPRO. The degraded data were used to evaluate the performance of a skin cancer detection algorithm. The Xenics and Opgal cameras achieved accuracies of 84.33% and 84.20%, respectively, and sensitivities of 83.03% and 83.23%, respectively. These values closely matched those from the non-degraded data, indicating that employing these lower-cost cameras is appropriate for skin cancer detection. The Seek camera achieved an accuracy of 82.13% and a sensitivity of 79.77%. Based on these results, we conclude that this camera is appropriate for less critical applications.

Lateral heat flux reduction using a lock-in thermography compensation method

The naturally diffusive heat flow in solids often results in differences in surface temperatures. Active thermography (AT) exploits such differences to gain information on the internal structure, morphology, or geometry of technical components or biological specimens. In contrast to sound or light waves, thermal waves are lossy; consequently, it is difficult to interpret measured 2D temperature fields. Most AT evaluation methods are based on 1D approaches, and measured 3D heat fluxes are frequently not considered, which is why edges, small features, or gradients are often blurred. Herein, we present a method for reducing the local temperature gradients at feature areas and minimizing the induced lateral heat flux in optical lock-in thermography (LT) measurements through spatial- and temporal-structured heating. The vanishing lateral gradients convert the problem into a 1D problem, which can be adequately solved by the LT approach. The proposed compensation method can bypass the blind frequency of LT and make the inspection largely independent of the excitation frequency. Furthermore, the edge sharpness and separability of features are improved, ultimately improving the feature-detection efficiency.

Skin Cancer Detection Using Infrared Thermography: Measurement Setup, Procedure and Equipment

Infrared thermography technology has improved dramatically in recent years and is gaining renewed interest in the medical community for applications in skin tissue identification applications. However, there is still a need for an optimized measurement setup and protocol to obtain the most appropriate images for decision making and further processing. Nowadays, various cooling methods, measurement setups and cameras are used, but a general optimized cooling and measurement protocol has not been defined yet. In this literature review, an overview of different measurement setups, thermal excitation techniques and infrared camera equipment is given. It is possible to improve thermal images of skin lesions by choosing an appropriate cooling method, infrared camera and optimized measurement setup.

A simple non-contact optical method to quantify in-vivo sweat gland activity and pulsation

OBJECTIVE

Most methods for monitoring sweat gland activity use simple gravimetric methods, which merely measure the average sweat rate of multiple sweat glands over a region of skin. It would be extremely useful to have a method which could quantify individual gland activity in order to improve the treatment of conditions which use sweat tests as a diagnostic tool, such as hyperhidrosis, cystic fibrosis, and peripheral nerve degeneration.

METHODS

An optical method using an infrared camera to monitor the skin surface temperature was developed. A thermodynamics computer model was then implemented to utilize these skin temperature values along with other environmental parameters, such as ambient temperature and relative humidity, to calculate the sweat rates of individual glands using chemically stimulated and unstimulated sweating. The optical method was also used to monitor sweat pulsation patterns of individual sweat glands.

RESULTS

In this preliminary study, the feasibility of the optical approach was demonstrated by measuring sweat rates of individual glands at various bodily locations. Calculated values from this method agree with expected sweat rates given values found in literature. In addition, a lack of pulsatile sweat expulsion was observed during chemically stimulated sweating, and a potential explanation for this phenomenon was proposed.

CONCLUSION

A simple, non-contact optical method to quantify sweat gland activity in-vivo was presented.

SIGNIFICANCE

This method allows researchers and clinicians to investigate several sweat glands simultaneously, which has the potential to provide more accurate diagnoses and treatment as well as increase the potential utility for wearable sweat sensors.

Dynamic thermal imaging for pigmented basal cell carcinoma and seborrheic keratosis

BACKGROUND

Clinical differentiation between pigmented basal cell carcinoma (BCC) and seborrheic keratosis (SK) can sometimes be difficult. Noninvasive diagnostic technologies, such as thermal imaging, can be helpful in these situations. This study explored the use of dynamic thermal imaging (DTI), which records thermal images after the application of external thermal stimuli (heat or cold) for the differential diagnosis of pigmented BCC and SK.

MATERIALS AND METHODS

Twenty-two patients with pigmented BCC and 15 patients with SK participated in this study. Dynamic thermal images of lesions (pigmented BCC or SK) and control sites (contralateral normal skin) were recorded after the heat and cold stimuli. Temperature changes in the region of interest (ROI) are plotted as a thermal response graph. After fitting an exponential equation to each thermal response graph, the rate constants were compared between groups (pigmented BCC versus control, SK versus control).

RESULTS

The thermal response graphs revealed that the average temperature of pigmented BCC showed faster thermal recovery to baseline than the control site. There was a significant difference in the rate constants of the fitted exponential equations between the pigmented BCCs and the control sites (p<.001). However, we did not find a significantly different thermal recovery pattern between SK lesions and control sites.

CONCLUSIONS

DTI can be used as a diagnostic tool for distinguishing pigmented BCC from SK by comparing thermal recovery patterns between target lesions (pigmented BCC or SK) and the control site.

Infrared Thermal Imaging of Patients With Acute Upper Respiratory Tract Infection: Mixed Methods Analysis

Background

Upper respiratory tract infection is a common disease of the respiratory system. Its incidence is very high, and it can even cause pandemics. Infrared thermal imaging (IRTI) can provide an objective and quantifiable reference for the visual diagnosis of people with acute respiratory tract infection, and it can function as an effective indicator of clinical diagnosis.

Objective

The aims of this study are to observe and analyze the infrared expression location and characteristics of patients with acute upper respiratory tract infection through IRTI technology and to clearly express the quantification of temperature, analyze the role of IRTI in acute upper respiratory tract diagnostic research, and understand the impact of IRTI in qualitative and quantitative research.

Methods

From December 2018 to February 2019, 154 patients with acute upper respiratory tract infection were randomly selected from the emergency department of the First Affiliated Hospital of Guangzhou Medical University. Among these patients, 73 were men and 81 were women. The subjects were divided into two groups according to the presence of fever, namely, fever and nonfever groups. Qualitative and quantitative analyses of the infrared thermal images were performed to compare the results before and after application of the technology.

Results

Using the method described in this paper, through the analysis of experimental data, we elucidated the role of IRTI in the diagnosis of acute upper respiratory tract infection, and we found that qualitative and quantitative IRTI analyses play important roles. Through the combination of theory and experimental data, the IRTI analysis showed good results in identifying acute upper respiratory tract infection.

Conclusions

IRTI technology plays an important role in identifying the infrared expression location and characteristics of patients with acute upper respiratory tract infection as well as in the quantification of clear expression of body temperature, and it provides an objective and quantifiable reference basis for elucidating the pathogenesis of these patients.

Thermography as a non-ionizing quantitative tool for diagnosing periapical inflammatory lesions

Background

Thermography is a contemporary imaging modality based on acquiring and analyzing thermal data using non-contact devices. The aim of the present study was to assess the validity of thermography, compared with that of the reference-standard, for the diagnosis of periapical inflammatory lesions and to evaluate the temperature ranges for acute pulpitis with apical periodontitis (AAP), acute periapical abscess (AA) and chronic periapical abscess (CA).

Methods

AAP, AA and CA were diagnosed based on clinical and radiographic criteria. Thermographic data were acquired using the FLIR E-5 Infrared Camera. Extraoral thermal images were taken from the front and right and left sides of patients whose mouths were closed, and one intraoral thermal image was taken from the palatal perspective. Agreement in the diagnoses based on the combination of clinical and radiographic assessments and the thermographic evaluation was calculated. The temperature ranges of the three diagnostic subgroups were also measured.

Results

A total of 80 patients were enrolled in this study. The mean intraoral thermal image temperature for AA was 37.26 ± 0.36, that for CA was 35.03 ± 0.63 and that for AAP was 36.07 ± 0.45. The differences between the mean intraoral thermal temperatures of the three diagnostic groups were statistically significant (P < 0.001). The result of the Kappa coefficient of agreement between the combination of clinical and radiographic assessments and the thermographic evaluation was significant (P < 0.001).

Conclusions

Thermography is an effective, quantitative and nonionizing approach that can be used for the diagnosis of periapical inflammatory lesions. The results of the present study indicated that the highest thermal image temperatures were recorded for AA. Thermography might be able to detect inflammatory reactions during the preclinical stage, leading to early diagnosis.

Low-Cost Active Thermography using Cellphone Infrared Cameras: from Early Detection of Dental Caries to Quantification of THC in Oral Fluid

Active thermography (AT) is a widely studied non-destructive testing method for the characterization and evaluation of biological and industrial materials. Despite its broad range of potential applications, commercialization and wide-spread adaption of AT has long been impeded by the cost and size of infrared (IR) cameras. In this paper, we demonstrate that this cost and size limitation can be overcome using cell-phone attachment IR cameras. A software development kit (SDK) is developed that controls camera attributes through a simple USB interface and acquires camera frames at a constant frame rate up to 33 fps. To demonstrate the performance of our low-cost AT system, we report and discuss our experimental results on two high impact potential applications. The first set of experiments is conducted on a dental sample to investigate the clinical potential of the developed low-cost technology for detecting early dental caries, while the second set of experiments is conducted on the oral-fluid based lateral flow immunoassay to determine the viability of our technology for detecting and quantifying cannabis consumption at the point-of-care. Our results suggest achievement of reliable performance in the low-cost platform, comparable to those of costly and bulky research-grade systems, paving the way for translation of AT techniques to market.

Numerical modelling of skin tumour tissue with temperature-dependent properties for dynamic thermography

Dynamic thermography has been clinically proven to be a valuable diagnostic technique for skin tumour detection as well as for other medical applications, and shows many advantages over static thermography. Numerical modelling of heat transfer phenomena in biological tissue during dynamic thermography can aid the technique by improving process parameters or by estimating unknown tissue parameters based on measurement data. This paper presents a new non-linear numerical model of multilayer skin tissue containing a skin tumour together with thermoregulation response of the tissue during the cooling-rewarming process of dynamic thermography. The thermoregulation response is modelled by temperature-dependent blood perfusion rate and metabolic heat generation. The aim is to describe bioheat transfer more realistically. The model is based on the Pennes bioheat equation and solved numerically using a subdomain BEM approach treating the problem as axisymmetrical. The paper includes computational tests for Clark II and Clark IV tumours, comparing the models using constant and temperature-dependent properties which showed noticeable differences and highlighted the importance of using a local thermoregulation model. Results also show the advantage of using dynamic thermography for skin tumour screening and detection at an early stage. One of the contributions of this paper is a complete sensitivity analysis of 56 model parameters based on the gradient of the surface temperature difference between tumour and healthy skin. The analysis shows that size of the tumour, blood perfusion rate, thermoregulation coefficient of the tumour, body core temperature and density and specific heat of the skin layers in which the tumour is embedded are important for modelling the problem, and so have to be determined more accurately to reflect realistic skin response of the investigated tissue, while metabolic heat generation and its thermoregulation are not.

Distinguishing melanocytic nevi from melanomas using static and dynamic infrared thermal imaging

BACKGROUND

The incidence rates of melanoma have risen to worrying levels over the last decade. Delayed diagnosis, due to faults on the detection stage, indicates the necessity of new aiding diagnosis techniques. Since metabolic activity is highly connected to neoplasia formation, a detection technique that focuses its results on vascular responses, as Infrared thermal (IRT), seems to be a viable option.

MATERIALS AND METHODS

Static and dynamic (cooling) thermal images of melanoma and melanocytic nevi lesions were collected and analysed to retrieve thermal parameters characteristic of this skin lesion types. The steady-state and dynamic variables were tested separately with different machine learning classifiers to verify whether the distinction of melanoma and nevi lesions was achievable.

RESULTS

The differentiation of both types of skin tumours was doable, achieving an accuracy of 84.2% and a sensitivity of 91.3% with the implementation of a learner based on support vector machines and an input vector composed by static variables.

CONCLUSION

The use of IRT for skin tumour classification is achievable, but some improvement is needed to raise the metrics of sensitivity and specificity. For future work, it is recommended the study of dynamic parameters for the classification of other types of skin neoplasia.

Application of dynamic thermal imaging in a photocarcinogenesis mouse model

INTRODUCTION

In clinical practice and experimental settings, cutaneous premalignant and malignant lesions are commonly diagnosed by histopathological biopsy. However, this technique is invasive and results in functional or cosmetic defects. Dynamic thermal imaging is a non-invasive technique that quantifies the infra-red (IR) radiation emitted by a subject after the introduction of external thermal stimuli (such as heat or cold).

METHODS

Forty hairless albino (Crl:SKH1-hr) mice were randomised to the control group or the experimental group. The experimental group was regularly irradiated with artificial ultraviolet. Clinical photographs, immunohistochemical staining and dynamic thermal imaging results of both groups were obtained.

RESULTS

As photocarcinogenesis proceeded, faster thermal recovery to basal temperature after heat stimuli was significant on dynamic thermal imaging. With histopathological correlations, it was possible to differentiate normal, premalignant and malignant cutaneous lesions according to thermal imaging results. CD 31 staining analysis showed that increased vasculature was the key change responsible for different thermal imaging results among photocarcinogenesis steps.

CONCLUSIONS

Dynamic thermal imaging is useful to differentiate normal, premalignant and malignant cutaneous lesions. Increased vasculature is the key change responsible for different thermal imaging results.

Dynamic thermal imaging on actinic keratosis patients: A preliminary study

BACKGROUND

Diagnosis of actinic keratosis (AK) based only on clinical findings can be misleading, and histopathological diagnosis results in scars. Dynamic thermal imaging is a potential non-invasive tool for the diagnosis of AK. This imaging technique quantifies the infrared (IR) radiation emitted by a subject after exposure to external thermal stimuli, such as heat or cold.

METHODS

Twenty-six histopathologically confirmed AK patients participated in the study. We compared the dynamic thermal images of AK lesions and normal skin (control sites). Temperature changes were plotted as a thermal response graph. After fitting exponential curves to the thermal response graph, the curve was converted to a logarithmic form.

RESULTS

Comparison of the early thermal response graphs of lesions and control sites showed faster thermal recovery of AK lesions. There was a significant difference in the gradient component of the calculated logarithmic equation between the AK lesions and control sites (P < 0.001).

CONCLUSION

Dynamic thermal imaging can be used as an auxiliary diagnostic tool for AK.

Skin cancer detection using non-invasive techniques

Skin cancer is the most common form of cancer and is globally rising. Historically, the diagnosis of skin cancers has depended on various conventional techniques which are of an invasive manner. A variety of commercial diagnostic tools and auxiliary techniques are available to detect skin cancer. This article explains in detail the principles and approaches involved for non-invasive skin cancer diagnostic methods such as photography, dermoscopy, sonography, confocal microscopy, Raman spectroscopy, fluorescence spectroscopy, terahertz spectroscopy, optical coherence tomography, the multispectral imaging technique, thermography, electrical bio-impedance, tape stripping and computer-aided analysis. The characteristics of an ideal screening test are outlined, and the authors pose several points for clinicians and scientists to consider in the evaluation of current and future studies of skin cancer detection and diagnosis. This comprehensive review critically analyses the literature associated with the field and summarises the recent updates along with their merits and demerits.

Assessment of lower extremity ischemia using smartphone thermographic imaging

Conventional diagnostic modalities for assessing arterial circulation or tissue perfusion include blood pressure measurement, ultrasound evaluation, and contrast-based angiographic assessment. An infrared thermal camera can detect infrared radiation energy from the human body, which generates a thermographic image to allow tissue perfusion analysis. We describe a smartphone-based miniature thermal imaging system that can be used as an adjunctive imaging modality to assess tissue perfusion. This smartphone-based camera device is noninvasive, simple to use, and cost-effective in assessing patients with lower extremity tissue perfusion. Assessment of patients with lower extremity arterial ischemia can be performed by a variety of diagnostic modalities, including ankle-brachial index, absolute systolic ankle or toe pressure, transcutaneous oximetry, arterial Doppler waveform, arterial duplex ultrasound, computed tomography scan, arterial angiography, and thermal imaging. We herein describe a noninvasive imaging modality using smartphone-based infrared thermography.

Non-invasive tools for the diagnosis of cutaneous melanoma

BACKGROUND

While the excisional biopsy and histological examination of suspicious lesions remains the current gold standard for diagnosing cutaneous melanoma (CM), there is a demand for more objective and non-invasive examination methods that may support clinicians in their decision when to biopsy or not.

METHODS

This review is based on publications and guidelines retrieved by a selective search in PubMed and MEDLINE and focused on non-invasive diagnostic strategies for detecting melanoma.

RESULTS

Ten different non-invasive techniques were compared with regard to applicability, status of development, and resources necessary for introduction into clinical routine (dermoscopy, sequential digital dermoscopy, total body photography, computer-aided multispectral digital analysis, electrical impedance spectroscopy, Raman spectroscopy, reflectance confocal microscopy, multiphoton tomography, stepwise two-photon-laser spectroscopy, quantitative dynamic infrared imaging). In an effort to create a classification based on our analyses, we suggest to differentiate i) tools for screening of patients in daily clinical routine, ii) tools for examination of a restricted number of preselected lesions that produce an automated diagnostic score, iii) tools for examination of a restricted number of preselected lesions at specialized centers requiring extensive training, iv) devices at an experimental stage of development.

CONCLUSION

None of the discussed examination techniques is able to provide a definite and final diagnosis or to completely replace the histopathological examination. Up to date, the need for fully automated devices offering a complete skin cancer screening has not been satisfied.

[Strategies for the noninvasive diagnosis of melanoma]

The diagnosis of advanced cutaneous melanoma may easily be made by the unaided eye, followed by excisional biopsy and histopathological examination. However, in the setting of melanoma screening examinations in high-risk patients with many nevi, dermatologists are challenged with the differentiation of atypical but benign nevi and early invasive or in situ melanomas. In this situation, there is a real need for additional, noninvasive examination techniques that may serve as an aide to decide for or against an excisional biopsy. Conventional dermoscopy is a well-established examination procedure and an increase in sensitivity was confirmed by two independent meta-analyses. Moreover, dynamic changes or newly developed pigmented lesions may be detected by sequential digital dermoscopy or (automated) total body photography, respectively. Over the past years, a number of medicinal products gained market access after licensing by American and European agencies for the noninvasive diagnosis of cutaneous neoplasms. These devices are based on technologies including in vivo reflectance confocal microscopy, multispectral analysis, electrical impedance spectroscopy, or Raman spectroscopy. Other technologies are still on the verge of becoming less experimental but more clinically applicable for diagnosing melanoma (in vivo multiphoton tomography, stepwise two-photon laser spectroscopy, infrared thermal image analysis, epidermal genetic information retrieval). This review provides a concise overview of general principles and sheds light on indication and added value for dermatologists.

TERMOGRAFIA MÉDICA INFRAVERMELHA APLICADA À MEDICINA DO ESPORTE

RESUMO A termografia médica infravermelha é um instrumento de análise não invasiva e não radioativa, capaz de analisar funções fisiológicas relacionadas com o controle da temperatura da pele. A termografia detecta a luz infravermelha emitida pelo corpo e visualiza mudanças de temperatura corporal relacionadas à alteração no fluxo sanguíneo. Não é um método que mostra anormalidades anatômicas, porém é capaz de mostrar mudanças fisiológicas. Existem várias aplicações da termografia no campo da medicina: desordens neurológicas, reumatológicas, musculares, doenças vasculares, patologias urológicas, ginecológicas, ortopédicas e na medicina esportiva. Para todas as áreas médicas, a termografia está estabelecida como uma medida que proporciona um mapeamento visual da distribuição da temperatura da pele. A termografia não deve ser usada como ferramenta diagnóstica única. Exames clínicos devem ser realizados para interpretação dos termogramas. Nas aplicações médicas, esta técnica proporciona, somente, uma imagem da distribuição da temperatura da pele; não é capaz de mostrar dados de uma superfície profunda do corpo, como é possível por outros exames de imagem. Entretanto, é um método não-invasivo e objetivo, além de seguro e inofensivo. Na medicina do esporte, o uso da termografia pode proporcionar melhores resultados aos atletas por ser um instrumento na identificação de riscos e na prevenção de lesões, além de ser uma importante ferramenta no acompanhamento do treinamento esportivo, a partir da avaliação da quantificação da carga de trabalho.

The efficacy of a photolyase-based device on the cancerization field: a clinical and thermographic study

Background

At skin level, a cancerization field (CF) indicates some chronically photoexposed areas in which, besides a primary tumor, histological or biomolecular modifications without clinical signs are present. Active telethermography (ATT) allows us to observe the imaging of a hyperthermic halo (HH) surrounding the tumor . The Authors hypothesize HH as a possible expression of CF.

Objectives

The aim of this study were to verify whether HHs have the same histological or immunohistochemical characteristics as the CF and, secondly, to evaluate the efficacy of a device containing the enzyme photolyase in modifying thermographic parameters in these area.

Methods

The study included 30 patients affected by actinic keratosis, evaluated clinically and by ATT at time 0 and after 3, 6 and 9 months.

Results

The ATT showed the presence of HHs in all the patients and, after the treatment, a significant modification of both the extension of these areas and the thermal parameters. In 5 patients for whom, while operated, two other biopsies were performed, respectively on the HH and on a perilesional non-hyperthermic area, in the HH, we detected a p53 and Ki 67 over-expression.

Conclusions

Our results indicate that ATT could represent a useful paraclinic method in identifying CFs in subjects at risk.