Colorimetric analysis of images in the follow-up of infantile hemangiomas

Comparative Evaluation of Laser Therapy for Infantile Hemangiomas: A Systematic Review of Clinical Outcomes and Treatment Considerations

BACKGROUND AND OBJECTIVES

Infantile hemangiomas (IHs) are the most common benign vascular tumors in infancy. While many resolve spontaneously, treatment is often required due to ulceration, functional impairment, or aesthetic concerns. Laser therapy, either alone or in combination with beta-blockers, has become a central therapeutic option. However, optimal laser parameters, efficacy for different IH types, and safety remain under investigation. This systematic review evaluates the effectiveness and safety of various laser treatments for IHs, focusing on lesion regression, treatment protocols, recurrence, and adverse events.

STUDY DESIGN/MATERIALS AND METHODS

A systematic search was conducted following PRISMA guidelines in PubMed, Scopus, Web of Science, Embase, and the Cochrane Library. Studies published up to January 2025 were included. This review included 20 studies comprising a total of 2,856 patients. Included clinical studies evaluated laser therapy-alone or combined with pharmacological agents-and reported outcomes such as lesion regression, treatment duration, recurrence, and adverse effects.

RESULTS

The 595-nm pulsed dye laser (PDL) was the most studied and showed high efficacy for superficial IHs, with improvement rates up to 85%. The 1064-nm Nd:YAG laser was more effective for deeper lesions, achieving up to 87.57% regression. Combination therapies (e.g., PDL with propranolol or timolol) yielded better outcomes than monotherapy, with higher regression and lower recurrence. Dual-wavelength approaches also showed promise. Adverse effects were generally mild and infrequent.

CONCLUSION

Laser therapy is effective and well-tolerated for IHs. PDL is preferred for superficial lesions and Nd:YAG for deeper or mixed types. Standardized protocols are needed, and further research should refine therapeutic parameters and clinical guidelines.

The Evaluation, Diagnosis, and Management of Infantile Hemangiomas-A Comprehensive Review

Infantile hemangioma (IH) is the most common pediatric benign vascular tumor. Its pathogenesis is still poorly understood, and it usually appears during the first few weeks of life and follows a characteristic natural course of proliferation and involution. Most IHs are small, benign, resolve spontaneously, and do not require active treatment but only active observation. A minority of IHs are potentially problematic because they can cause life-threatening complications, permanent disfigurement, and functional impairment. Diagnosis is usually clinical, and propranolol is currently the mainstay of treatment. Other therapeutic modalities may be used alone or in combination, depending on the characteristics of the specific IH. New treatment options are being explored every day, and some are showing promising results. It is undeniable that therapeutic modalities for IHs must be selected based on the child's age, the size and location of the lesion, the presence of complications, the implementation conditions, and the possible outcomes of the treatment. The future of IH management will certainly be reflected in improved advanced imaging modalities, research into the genetic and molecular basis, the development of new pharmacological agents or techniques, and the development of standardized protocols, all to optimize outcomes with minimal side effects.

Digital Imaging and Artificial Intelligence in Infantile Hemangioma: A Systematic Literature Review

Infantile hemangioma (IH) is a vascular anomaly observed in newborns, with potential severe complications if left undetected. Consequently, researchers have turned to artificial intelligence (AI) and digital imaging (DI) methods for detection, segmentation, and assessing the treatment response in IH cases. This paper conducts a systematic literature review (SLR) following the Kitchenham framework to scrutinize the utilization of AI and digital imaging techniques in IH applications. A total of 21 research articles spanning from 2014 to April 2024 were carefully selected and analyzed to address four key research questions: the issues solved in IH using AI and DI, the most-used AI and DI techniques, the best-performing technique in detecting IH, and the limitations and future directions in the various fields of IH. After an extensive review of the selected articles, it was found that 10 of the 21 articles focused on detecting IH, and 15 articles utilized AI. However, the best-performing technique in detecting IH employed DI. Additionally, the SLR offers insights and recommendations into future directions for IH applications.

A Histogram Analysis of the Pixel Grayscale (Luminous Intensity) of B-Mode Ultrasound Images of the Subcutaneous Layer Predicts the Grade of Leg Edema in Pregnant Women

The technique most widely used to quantitatively measure leg edema is only a pitting edema method. It has recently become possible to digitize B-mode ultrasound images and accurately quantify their brightness using an image-analysis software program. The purpose of this study was to find new indices of the grade of leg skin, to study whether or not analyses of the subcutaneous layer of leg skin on ultrasound images using image-editing software program can be used to evaluate it and to digitize it. Images of 282 subcutaneous layers of leg skin in 141 pregnant women were obtained using a B-scan portable ultrasound device. Rectangular photographs (vertical: skin thickness; horizontal: width of probe) were obtained using an image-editing program, and the luminous intensity (pixel grayscale: 0-255) and thickness of the skin were calculated using a histogram. We investigated the correlation between these parameters and the grade of pitting edema (0-3). There was a significant positive correlation between the grade of pitting edema and the average luminous intensity value, its standard deviation, and the skin thickness (ρ = 0.36, ρ = 0.22, ρ = 0.51, p < 0.0001, respectively). In particular, there was strong positive correlation between the grade of pitting edema and both the total number of pixels in a rectangle × (multiplied by) the average luminous intensity value and the total number of pixels in a rectangle × the standard deviation of the average luminous intensity value (ρ = 0.58 and ρ = 0.59, p < 0.0001, respectively). We could quantitatively evaluate the grade of leg edema by analyzing ultrasound photographs of the subcutaneous layer of the leg skin using an image-editing software program and found new indices to digitize it.

Analysis of lesional color to differentiate infantile hemangiomas from port-wine birthmarks in infants less than 3 months old: A pilot study

BACKGROUND

In their early phase, infantile hemangiomas (IH) can sometimes be difficult to differentiate from port-wine birthmarks (PWB). Until recently, inexpensive diagnostic tools have not been readily available.

OBJECTIVE

To determine the diagnostic utility of widely available colorimetric technology when differentiating PWB from IH in photographs of infants less than 3 months old.

METHODS

Multi-center, retrospective analysis of RGB (red, green, and blue) and HSL (hue, saturation, lightness) values collected using electronic colorimeters from images of clinically confirmed untreated IH or PWB. Subgroup analysis of flat vascular birthmarks was subsequently performed.

RESULTS

Images of 119 IH (specifically, 45 flat IH) and 59 PWB were identified. PWB had significantly (P < .001) higher RGB values of all primary colors, most notably for blue and green (mean difference: >50), irrespective of thickness. RGB or RGB with HSL values had an excellent accuracy (90%), sensitivity (92%), specificity (98%), and positive predictive value (98%) when discriminating PWB from flat IH. IH could be distinctly clustered from PWB when combining their RGB with HSL values.

CONCLUSION

Electronic colorimeters with emphasis on blue and green values, are able to differentiate PWB from IH, irrespective of thickness, with a high degree of accuracy. A larger scale evaluation is now required.