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Ramirez-GarciaLuna JL, Bartlett R, Arriaga-Caballero JE, Fraser RDJ, Saiko G. Infrared Thermography in Wound Care, Surgery, and Sports Medicine: A Review. Front Physiol 2022; 13:838528. [PMID: 35309080 PMCID: PMC8928271 DOI: 10.3389/fphys.2022.838528] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/26/2022] [Indexed: 12/25/2022] Open
Abstract
For many years, the role of thermometry was limited to systemic (core body temperature) measurements (e.g., pulmonary catheter) or its approximation using skin/mucosa (e.g., axillary, oral, or rectal) temperature measurements. With recent advances in material science and technology, thermal measurements went beyond core body temperature measurements and found their way in many medical specialties. The article consists of two primary parts. In the first part we overviewed current clinical thermal measurement technologies across two dimensions: (a) direct vs. indirect and (b) single-point vs. multiple-point temperature measurements. In the second part, we focus primarily on clinical applications in wound care, surgery, and sports medicine. The primary focus here is the thermographic imaging modality. However, other thermal modalities are included where relevant for these clinical applications. The literature review identified two primary use scenarios for thermographic imaging: inflammation-based and perfusion-based. These scenarios rely on local (topical) temperature measurements, which are different from systemic (core body temperature) measurements. Quantifying these types of diseases benefits from thermographic imaging of an area in contrast to single-point measurements. The wide adoption of the technology would be accelerated by larger studies supporting the clinical utility of thermography.
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Affiliation(s)
- Jose L. Ramirez-GarciaLuna
- Swift Medical Inc., Toronto, ON, Canada
- Division of Experimental Surgery, McGill University, Montreal, QC, Canada
| | | | | | - Robert D. J. Fraser
- Swift Medical Inc., Toronto, ON, Canada
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Gennadi Saiko
- Swift Medical Inc., Toronto, ON, Canada
- Department of Physics, Ryerson University, Toronto, ON, Canada
- *Correspondence: Gennadi Saiko,
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Vergilio MM, Gomes G, Aiello LM, Fontana M, Aldred A, Ribeiro JADS, Gabbi TVB, Leonardi GR. Evaluation of skin using infrared thermal imaging for dermatology and aesthetic applications. J Cosmet Dermatol 2022; 21:895-904. [PMID: 35041761 DOI: 10.1111/jocd.14748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/03/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The use of thermography in the medical field has been experiencing a renaissance due to advances in the infrared thermographic imaging technology, which improves thermographic equipment and promises cost saving and increased safety. Dermatology is one of the most promising fields of application among the medical areas with potential for the use of thermography. OBJECTIVE To review the findings on this subject and to describe the use of such technique for dermatology and aesthetic applications. METHODS A bibliographic survey was carried out, selecting relevant publications and guidelines, focused on monitoring medical diagnostic applications and benefits of thermography for dermatology, inflammatory skin diseases, and aesthetic applications. RESULTS Inflammatory skin diseases lead to changes of the IRT image. A quantification of treatment effects and monitoring changes on skin can be possible by repeated measurements over time. CONCLUSION Infrared imaging is a noninvasive, powerful tool in the diagnosis and clinical management of skin conditions and monitoring of aesthetic procedures.
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Affiliation(s)
- Mariane Massufero Vergilio
- Graduate Program in Internal Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Guilherme Gomes
- Department of Physics and Interdisciplinary Science, University of São Paulo (IFSC-USP), São Carlos, SP, Brazil.,Predikta Soluções em Pesquisa, São Paulo, SP, Brazil
| | - Laura Moretti Aiello
- School of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Monique Fontana
- School of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | | | | | - Tatiana Villas Boas Gabbi
- Department of Dermatology, Hospital das Clínicas da Faculdade de Medicina (HC - FMUSP), University of São Paulo, São Paulo, SP, Brazil
| | - Gislaine Ricci Leonardi
- Graduate Program in Internal Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.,School of Pharmaceutical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
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3
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Ramirez-GarciaLuna JL, Wang SC, Yangzom T, Piguet V, Kirby JS, Alavi A. Use of thermal imaging and a dedicated wound imaging smartphone app as an adjunct to staging hidradenitis suppurativa. Br J Dermatol 2021; 186:723-726. [PMID: 34748648 DOI: 10.1111/bjd.20884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/01/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
Hidradenitis suppurativa (HS) presents with painful nodules, draining tunnels, abscesses, ulcers, and fistula formation1 . Grading systems, (e.g. Hurley Staging System, International Hidradenitis Suppurativa Severity Score System (IHS4), Severity Assessment of Hidradenitis Suppurativa Score (HS-PGA score), and Hidradenitis Suppurativa Area and Severity Index (HASI)) assess disease severity in terms of lesion count, extension and morphology.
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Affiliation(s)
- J L Ramirez-GarciaLuna
- Division of Experimental Surgery, McGill, University Health Centre, Montreal, Quebec, Canada.,Swift Medical, Toronto, Ontario, Canada
| | - S C Wang
- Division of Dermatology, McGill, University Health Centre, Montreal, Quebec, Canada.,Swift Medical, Toronto, Ontario, Canada
| | - T Yangzom
- Swift Medical, Toronto, Ontario, Canada
| | - V Piguet
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada.,Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
| | - J S Kirby
- Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - A Alavi
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada.,Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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4
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Derruau S, Bogard F, Exartier-Menard G, Mauprivez C, Polidori G. Medical Infrared Thermography in Odontogenic Facial Cellulitis as a Clinical Decision Support Tool. A Technical Note. Diagnostics (Basel) 2021; 11:diagnostics11112045. [PMID: 34829390 PMCID: PMC8624025 DOI: 10.3390/diagnostics11112045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Odontogenic cellulitis are frequent infections of the head and neck fascial spaces that can sometimes spread and be life-threatening, requiring urgent hospitalization. Early diagnosis of facial cellulitis with diffuse inflammatory process is crucial in patient management but not always obvious in the field. Medical infrared thermography (MIT) is a noninvasive tool increasingly used to evaluate skin temperature maps and delineate inflammatory lesions. Objective: The aim of this work was to evaluate the use of MIT to improve the clinical examination of patients with facial cellulitis. Methods: Image processing work was carried out to highlight the thermal gradient resulting from inflammation linked to infection, in 2 patients with facial cellulitis. Results: In real-time, MIT allowed to precisely locate the inflammatory focus linked to cellulitis with no propagation to danger areas such as infraorbital space or around pharyngeal axis. Conclusions: Here, we show the first cases using MIT as a powerful complementary tool in the clinical evaluation of patients with facial cellulitis. Significance: This technology could help optimize the hospitalization decision through a facilitated assessment of infection spread in head and neck tissues and helping to incision for drainage.
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Affiliation(s)
- Stéphane Derruau
- UFR Odontologie, Université de Reims Champagne-Ardenne, 51100 Reims, France; (G.E.-M.); (C.M.)
- Pôle de Médecine Bucco-Dentaire, Service de Chirurgie Orale, Centre Hospitalier Universitaire de Reims, 51092 Reims, France
- BioSpecT EA-7506, UFR Pharmacie, Université de Reims Champagne-Ardenne, 51096 Reims, France
- Correspondence:
| | - Fabien Bogard
- MATIM EA, UFR Sciences, Université de Reims Champagne-Ardenne, 51687 Reims, France; (F.B.); (G.P.)
| | - Guillaume Exartier-Menard
- UFR Odontologie, Université de Reims Champagne-Ardenne, 51100 Reims, France; (G.E.-M.); (C.M.)
- Pôle de Médecine Bucco-Dentaire, Service de Chirurgie Orale, Centre Hospitalier Universitaire de Reims, 51092 Reims, France
| | - Cédric Mauprivez
- UFR Odontologie, Université de Reims Champagne-Ardenne, 51100 Reims, France; (G.E.-M.); (C.M.)
- Pôle de Médecine Bucco-Dentaire, Service de Chirurgie Orale, Centre Hospitalier Universitaire de Reims, 51092 Reims, France
- BIOS EA-4691, UFR Pharmacie, Université de Reims Champagne-Ardenne, 51096 Reims, France
| | - Guillaume Polidori
- MATIM EA, UFR Sciences, Université de Reims Champagne-Ardenne, 51687 Reims, France; (F.B.); (G.P.)
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Vaughn S, Ruthazer R, Rosenblatt A, Jenkins RL, Sorcini AP, Schnelldorfer T. Long-Wave Infrared Imaging for Intraoperative Cancer Detection-What is the True Temperature of a Cancer? Surg Innov 2021; 29:378-384. [PMID: 34637364 DOI: 10.1177/15533506211046096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND During cancer operations, the cancer itself is often hard to delineate-buried beneath healthy tissue and lacking discernable differences from the surrounding healthy organ. Long-wave infrared, or thermal, imaging poses a unique solution to this problem, allowing for the real-time label-free visualization of temperature deviations within the depth of tissues. The current study evaluated this technology for intraoperative cancer detection. METHODS In this diagnostic study, patients with gastrointestinal, hepatobiliary, and renal cancers underwent long-wave infrared imaging of the malignancy during routine operations. RESULTS It was found that 74% were clearly identifiable as hypothermic anomalies. The average temperature difference was 2.4°C (range 0.7 to 5.0) relative to the surrounding tissue. Cancers as deep as 3.3 cm from the surgical surface were visualized. Yet, 79% of the images had clinically relevant false positive signals [median 3 per image (range 0 to 10)] establishing an accuracy of 47%. Analysis suggests that the degree of temperature difference was primarily determined by features within the cancer and not peritumoral changes in the surrounding tissue. CONCLUSION These findings provide important information on the unexpected hypothermal properties of intra-abdominal cancers, directions for future use of intraoperative long-wave infrared imaging, and new knowledge about the in vivo thermal energy expenditure of cancers and peritumoral tissue.
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Affiliation(s)
- Stephanie Vaughn
- Department of Surgery, 2094Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Robin Ruthazer
- Biostatistics, Epidemiology, and Research Design Center, Tufts Clinical and Translational Science Institute, 1867Tufts Medical Center, Boston, MA, USA
| | - Andrew Rosenblatt
- Department of Surgery, 2094Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Roger L Jenkins
- Department of Surgery, 2094Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Andrea P Sorcini
- Department of Surgery, 2094Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Thomas Schnelldorfer
- Department of Biomedical Engineering, Tufts University, Medford, MA, USA.,Division of Surgical Oncology, Tufts Medical Center, Boston, MA, USA.,Department of Translational Research, Lahey Hospital and Medical Center, Burlington, MA, USA
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Medical infrared thermography as hidradenitis suppurativa diagnostic tool: literature review. Postepy Dermatol Alergol 2021; 38:32-35. [PMID: 34408563 PMCID: PMC8362785 DOI: 10.5114/ada.2021.104274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/11/2020] [Indexed: 11/22/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a rare, chronic, inflammatory skin disease that has a strong impact on the quality of life. Medical infrared thermography (MIT) is a non-invasive imaging method that could be used for evaluation of skin inflammation, which is an important biomarker in HS. We performed a comprehensive review of the literature to verify the possibilities of using MIT for HS. Key words “hidradenitis suppurativa”, “acne inversa” and “thermography” were used for PubMed, Embase and Scopus literature analysis and in total four articles fulfilled the inclusion criteria. The inflamed areas have shown the increase in temperature (34.3°C) and after the removal of lesions the temperature has become similar to the healthy skin sites. The margins of the inflammatory lesions identified by MIT were used in the surgical treatment. Also, MIT was used in combination with other imaging tests for inflammation evaluation. Thermography is an advantageous tool to detect inflammation and to secure the success of surgical treatment.
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Gutfilen-Schlesinger G, Lopes de Souza SA, Gutfilen B. Should We Scan Hidradenitis Suppurativa Patients? A Systematic Review of Radiologic Findings. Adv Skin Wound Care 2021; 34:1-10. [PMID: 34125731 DOI: 10.1097/01.asw.0000753196.64470.6a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To bring awareness and close gaps between dermatologists and radiologists about the contribution of imaging techniques for diagnosis, treatment, and follow-up of hidradenitis suppurativa (HS). DATA SOURCES Investigators searched the PubMed database for articles on HS and radiology techniques. STUDY SELECTION Databases were searched up to December 2018. The query retrieved 257 publications, of which 103 were unique; of these, 7 were inaccessible. From the remaining 96, 33 were irrelevant (did not discuss HS lesion features). After applying the inclusion criteria, 63 studies were relevant to this study. DATA EXTRACTION A standardized form was constructed to extract data from eligible studies by two independent authors. DATA SYNTHESIS Imaging techniques are significant and useful tools in HS management. Imaging should be carried out to evaluate disease severity, subclinical features, treatment success, and intraoperative patient assessment. Providers should consider nonconventional radiology techniques, which are underused in clinical management of HS. Further, dermatology and radiology require a shared terminology of disease features to better understand patient status. CONCLUSIONS Publications on HS lesion imaging have increased over the years. Imaging techniques have proven useful for determining HS severity and treatment effectiveness, as well as intraoperative patient assessment. These authors strongly recommend the use of these techniques in routine clinical practice for patients with HS.
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Affiliation(s)
- Gabriel Gutfilen-Schlesinger
- At the Universidade Federal do Rio de Janeiro, Brazil, Gabriel Gutfilen-Schlesinger, MSc, is PhD Student, Postgraduate Program of Medicine; Sergio Augusto Lopes de Souza, PhD, is Associate Professor, Department of Radiology; and Bianca Gutfilen, PhD, is Full Professor, Department of Radiology. Acknowledgments: The authors thank José Marcos Telles da Cunha, MD, PhD, for his thoughtful insights during various stages of manuscript preparation. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (Finance Code 001) and the Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro. The authors have disclosed no other financial relationships related to this article. Submitted October 23, 2020; accepted in revised form January 7, 2021
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8
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Delarue M, Derruau S, Troyon P, Bogard F, Polidori G, Mauprivez C. Medical infrared thermography in peri-operative management of peripheral ameloblastoma: A case report. Photodiagnosis Photodyn Ther 2021; 34:102167. [PMID: 33401022 DOI: 10.1016/j.pdpdt.2020.102167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/23/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
Peripheral ameloblastoma (PA) is a rare benign peripheral odontogenic tumor arising in the gingiva and in the overlying mucosa of tooth-bearing areas of the jaws. Recent data suggestthat the recurrence rate is directly related to inadequate surgical excision. This case of a 71-year-old man reports a poorly delineated mass effecting the gum of the left mandibular canine-premolars area histologically corresponded to PA. In complement to clinical visual examination of such a poorly delineated, non-exophytic and non-dyschromic inflammatory lesion, medical infrared thermography (MIT) - a non-invasive, non-ionizing and real-time imaging technique - was used to optimize the soft tissue margins, and a marginal bone resection was performed. MIT has also been found to be a useful tool in monitoring the absence of diseased tissue crossing the excisional margins at the end of the operation to minimize the risk of recurrence. After two years of follow-up, no local recurrence was found.
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Affiliation(s)
- Maxime Delarue
- Resident of Oral Surgery, Pôle d'Odontologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire, Reims, France.
| | - Stéphane Derruau
- Université de Reims Champagne-Ardenne, UFR Odontologie, Reims, France - Centre Hospitalier, Universitaire de Reims, Pôle de Médecine Bucco-dentaire, Reims, France - BioSpecT EA-7506, UFR dePharmacie, Reims, France
| | - Paul Troyon
- Resident, Pôle de Biologie Médicale et Pathologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire, Reims, France
| | | | | | - Cédric Mauprivez
- Pôle d'Odontologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire, Reims, Laboratoire EA4691 Biomatériaux et Inflammation en Site Osseux, Université Reims Champagne Ardennes, Reims, France
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9
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Santos L, Catelani F, Mayworm S, Quinart H, Machado CB, Taïar R. Effect of a wellness room with a physiotherapist in an intimate fashion company on ergonomics: stress level, quality of life and musculoskeletal symptoms. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2020. [DOI: 10.1080/1463922x.2020.1780343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Laura Santos
- Associação Pestalozzi, Duas Barras, Rio de Janeiro, Brazil
| | - Fernanda Catelani
- Raul Sertã Municipal Hospital, Nova Friburgo, Rio de Janeiro, Brazil
| | - Sandra Mayworm
- Estácio de Sá University, Niterói, Rio de Janeiro, Brazil
| | | | | | - Redha Taïar
- University of Reims, Reims Champagne-Ardenne, France
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10
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Immediate Effect of Whole-Body Vibration on Skin Temperature and Lower-Limb Blood Flow in Older Adults with Type 2 Diabetes: Pilot Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10020690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to evaluate the response of a single whole-body vibration (WBV) training session to peripheral skin temperature and peripheral blood flow of older adults with type 2 diabetes. A double-blind, controlled clinical trial was conducted following the Consolidated Standards of Reporting Trials (CONSORT) guidelines. A single session of WBV (24 Hz; amplitude 4 mm; vibration time 45 s, with a series of eight repetitions with recovery between repetitions of 30 s; total time of 10 min) or sham vibration on the Kikos P204 Vibrating Platform was employed. To assess skin temperature, the FLIR E40bxs thermographic camera and the ultrasonic vascular Doppler for flow velocity were used. Evaluation occurred before and after a WBV or sham intervention. The sample consisted of three men and 17 women. In the WBV group, there was a decrease in the temperature from 29.7 °C (±1.83) to 26.6 °C (±2.27), with p = 0.01. Temperature following sham decreased from 28.6 °C (±1.84) to 26.3 °C (±2.49), with p = 0.01. Regarding blood flow, there was a decrease in the analyzed arteries, especially the left posterior tibial artery, where there was a statistically significant flow reduction from 27.1 m/s (±25.36) to 20.5 m/s (±19.66), post WBV (p = 0.01). In the sham group, an increased flow velocity was observed for all the arteries analyzed, except for the left dorsal artery. Immediately following a full-body vibration session, peripheral skin temperature and lower-limb blood flow tend to decrease in diabetic patients. However, from the design of study developed, we cannot infer the maintenance of this effect in the medium and long term.
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11
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Semi-Quantitative Comparison of Infrared Thermography with Indocyanine Green Imaging in Porcine Intestinal Resection. Ing Rech Biomed 2019. [DOI: 10.1016/j.irbm.2019.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Elkin K, Daveluy S, Avanaki K. Review of imaging technologies used in Hidradenitis Suppurativa. Skin Res Technol 2019; 26:3-10. [PMID: 31595571 DOI: 10.1111/srt.12772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Until recently, clinical assessment with manual palpation of the HS lesions was the primary means to detect HS lesions and their borders. In the past decade, there has been increased application of imaging technologies to HS patients, and it is reported that manual palpation consistently underestimates HS. Of the technologies, ultrasound (US) imaging has been the most efficacious and well-studied. In the present review, we will discuss the various imaging modalities that aid in detecting, managing, and treating HS. MATERIALS AND METHODS Non-invasive HS imaging technologies including ultrasound (US) imaging, magnetic resonance imaging (MRI), medical infrared thermography (MIT), positron emission topography (PET), and computed tomography (CT) were reviewed and compared through a review of the literature. PubMed, Google, and Google Scholar were utilized. RESULTS Of the 4 HS technologies reviewed, US imaging and MRI are the most established and useful non-invasive modalities utilized in HS patients. However, MIT may have potential to aid in the pre-operative and intra-operative surgical excision of HS lesions. CONCLUSION For imaging HS lesions, US imaging is the most well-characterized and has the greatest range of use, while MRI has a role in severe, anogenital HS lesions. MIT of HS lesions is a novel application and merits attention.
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Affiliation(s)
- Kenneth Elkin
- Wayne State University School of Medicine, Detroit, Michigan
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan
| | - Kamran Avanaki
- Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan.,Department of Biomedical Engineering, Engineering Faculty, Wayne State University, Detroit, Michigan
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Anzengruber F, Alotaibi F, Kaufmann LS, Ghosh A, Oswald MR, Maul JT, Meier B, French LE, Bonmarin M, Navarini AA. Thermography: High sensitivity and specificity diagnosing contact dermatitis in patch testing. Allergol Int 2019; 68:254-258. [PMID: 30598404 DOI: 10.1016/j.alit.2018.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/31/2018] [Accepted: 11/12/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patch testing of contact allergens to diagnose allergic contact dermatitis (ACD) is a traditional, useful tool. The most important decision is the distinction between allergic and irritant reactions, as this has direct implications on diagnosis and management. Our objective was to evaluate a new method of non-contact infrared reading of patch tests. Secondary objectives included a possible correlation between the intensity of the patch test reaction and temperature change. METHODS 420 positive reactions from patients were included in our study. An independent patch test reader assessed the positive reactions and classified them as allergic (of intensity + to +++) or irritant (IR). At the same time, a forward-looking infrared (FLIR) camera attachment for an iPhone was used to acquire infrared thermal images of the patch tests, and images were analyzed using the FLIR ONE app. RESULTS Allergic patch test reactions were characterized by temperature increases of 0.72 ± 0.67 °C compared to surrounding skin. Irritant reactions only resulted in 0.17 ± 0.31 °C temperature increase. The mean temperature difference between the two groups was highly significant (p < 0.0001) and therefore was used to predict the type of contact dermatitis. CONCLUSIONS Thermography is a reliable and effective way to distinguish between allergic and irritant contact dermatitis.
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Affiliation(s)
- Florian Anzengruber
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Fayez Alotaibi
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Lilian S Kaufmann
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Adhideb Ghosh
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland; Competence Center Personalized Medicine, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Martin R Oswald
- Department of Computer Science, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Barbara Meier
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Lars E French
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Mathias Bonmarin
- School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Alexander A Navarini
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland; Competence Center Personalized Medicine, University of Zurich and ETH Zurich, Zurich, Switzerland.
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14
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Zouboulis CC, Nogueira da Costa A, Jemec GBE, Trebing D. Long-Wave Medical Infrared Thermography: A Clinical Biomarker of Inflammation in Hidradenitis Suppurativa/Acne Inversa. Dermatology 2019; 235:144-149. [PMID: 30650424 DOI: 10.1159/000495982] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/03/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A more reliable classification of skin inflammation and severity of active disease results from ultrasound sonography and the new hidradenitis suppurativa/acne inversa (HS) classification system IHS4. However, an objective assessment of skin inflammation in a continuous mode is still the ultimate goal. Long-wave medical infrared thermography (MIT) may offer a blood flow and temperature differential assessment in inflammatory conditions. OBJECTIVE To evaluate the application of MIT in HS. METHODS Standardized photography of the areas involved or been candidates for HS involvement was performed and MIT pictures were taken simultaneously and superimposed on the photographs of 18 patients (11 female, 7 male, median age 38.75 years [95% confidence interval 28.5 and 51 years], Hurley score I 5.6%, Hurley score II 38.9%, and Hurley score III 55.5%). A modification of the Otsu's method facilitated the automatic lesion segmentation from the background, depicting the inflammation area. Moreover, MIT was administered in real-time mode during radical HS surgery. RESULTS A 1°C temperature difference from a corresponding symmetric body region was indicative of inflammation. MIT figures detected a gradual increase of skin temperature from 33.0°C in healthy skin on average to 35.0-36.6°C at the center of inflamma tory lesions in the axilla and to 35.4-36.9°C at the center of inflammation in the groin area. Real-time MIT assessment enabled the definition of the margins and depth of the surgical intervention during the procedure. CONCLUSION MIT is a promising tool for the detection of inflammation severity in HS lesions and can be used as a clinical biomarker in evaluation studies of medical and surgical HS treatment.
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Affiliation(s)
- Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany, .,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany,
| | - André Nogueira da Costa
- Experimental Medicine and Diagnostics, Global Exploratory Development, UCB BioPharma SPRL, Braine-L'Alleud, Belgium
| | - Gregor B E Jemec
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark
| | - Dietrich Trebing
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
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Automatic detection of perforator vessels using infrared thermography in reconstructive surgery. Int J Comput Assist Radiol Surg 2018; 14:501-507. [PMID: 30519870 DOI: 10.1007/s11548-018-1892-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Knowing the location of the blood vessels supplying the skin and subcutaneous tissue is a requirement during the planning of tissue transfer in reconstructive surgery. Commonly used imaging techniques such as computed tomography angiography and indocyanine green angiography expose the patient to radiation or a contrast agent, respectively. Infrared thermal imaging was evaluated with success as a non-invasive alternative. To support the interpretation of thermograms, a method to automatically detect the perforators was developed and evaluated. METHODS A system consisting of a thermal camera, a PC and custom software was developed. The temperature variations of the skin surface were analysed to extract the perforator locations. A study was conducted to assess the performance of the algorithm by comparing the detection results of the algorithm with manually labelled thermal images by two clinicians of the deep inferior epigastric perforator flap of 20 healthy volunteers. RESULTS The F measure, precision and recall were used to evaluate the system performance. The median F measure is 0.833, the median precision is 0.80, and the median recall is 0.907. CONCLUSION The results of this study showed that it is possible to automatically and reliably detect the skin perforators in thermograms despite their weak temperature signature. Infrared thermal imaging is a non-invasive and contactless approach suitable for intraoperative use. Combined with a computer-assisted tool for the automatic detection of perforator vessels, it is a relevant alternative intraoperative imaging method to the standard indocyanine green angiography.
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16
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Zouboulis CC, Nogueira da Costa A. Standardized Photographic Documentation of Hidradenitis Suppurativa/Acne Inversa. Dermatology 2018; 235:51-54. [PMID: 30368496 DOI: 10.1159/000493342] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 08/28/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite existing guidelines and methods for standardized clinical photography in dermatology and plastic surgery, human skin exhibits exquisite site-specific morphologies and functions, and each body region can exhibit an individual pathologic phenotype. The aim of this work was to develop a standardized, representative and reproducible documentation of the multilocular hidradenitis suppurativa/acne inversa (HS) lesions, a disease mostly occurring in skin folds. METHOD Optimal body positions for medical photography of candidate areas for HS involvement were evaluated. Pictures of volunteers were taken, and indicative scientific graphics were designed. RESULTS Due to the variability of HS lesions and the fact of their localization in skin folds, a standardized, reproducible photographic documentation of HS candidate skin areas (50 cm from the skin surface) is proposed. The photographic series includes: (1) right armpit, (2) left armpit, (3) right groin, (4) left groin, (5) genital area, (6) anal area and anal fold, (7) right buttock, (8) left buttock, (9) chest area, (10) mons pubis, (11) right submammary area (females), (12) left submammary area (females). The protocol is accompanied with indicative scientific graphics for photography-proper positioning of the relevant body parts for documentation of potentially flat skin areas. In addition, former proposals for technical standardization of photography in dermatology, regarding instrumentation, environmental lighting and background colour, have to be respected. CONCLUSION Standardized photography of candidate skin areas for HS involvement will allow longitudinal intraindividual and interindividual evaluation of the disease course as well as prospective and retrospective comparative studies.
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Affiliation(s)
- Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, .,European Hidradenitis Suppurativa Foundation e.V., Dessau-Rosslau,
| | - André Nogueira da Costa
- Experimental Medicine and Diagnostics, Global Exploratory Development, UCB BioPharma SPRL, Braine L'Alleud, Belgium
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Derruau S, Renard Y, Pron H, Taiar R, Abdi E, Polidori G, Lorimier S. Combining Magnetic Resonance Imaging (MRI) and Medical Infrared Thermography (MIT) in the pre- and peri-operating management of severe Hidradenitis Suppurativa (HS). Photodiagnosis Photodyn Ther 2018; 23:9-11. [DOI: 10.1016/j.pdpdt.2018.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/16/2018] [Accepted: 05/10/2018] [Indexed: 10/16/2022]
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18
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Medical Infrared Thermography in back pain osteopathic management. Complement Ther Med 2018; 39:19-23. [DOI: 10.1016/j.ctim.2018.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/18/2018] [Accepted: 05/16/2018] [Indexed: 11/23/2022] Open
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