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PubMed2002

Juvenile-onset localized scleroderma activity detection by infrared thermography.

OBJECTIVE: The aim of this study was to define the clinical utility of infrared thermography in disease activity detection in localized scleroderma (LS). METHODS: We retrospectively reviewed 130 thermal images of 40 children with LS and calculated the sensitivity and specificity of thermography, comparing clinical descriptions of the lesions and contemporary thermographs. The reproducibility of thermography was calculated by using the weighted kappa coefficient to determine the level of agreement between two clinicians who reviewed the thermographs independently. RESULTS: The sensitivity of thermography was 92% and specificity was 68%. Full concordance between the two clinicians was observed in 91% of lesions, with a kappa score of 0.82, implying very high reproducibility of this technique. CONCLUSION: Our results demonstrate that thermography is a promising diagnostic tool when associated with clinical examination in discriminating disease activity, as long as it is applied to lesions without severe atrophy of the skin and subcutaneous fat. Further evaluation is needed to determine whether thermography can predict the future progression of lesions.

Age of Onset↗
PubMed1993

Thermography as a diagnostic aid in sciatica.

Thermography has been proposed as a diagnostic aid in patients with sciatica. Supporters of thermography state that: (a) normal patients have normal thermograms of their lower extremities, and (b) abnormal patients (with disk ruptures causing sciatica) have abnormal thermograms. To test these two hypotheses, 56 patients with clinically documented acute sciatica, with a supporting diagnostic study [computed tomography (CT), CT/myelography, and/or magnetic resonance imaging] showing a ruptured disk, had presurgical thermograms. One year after surgical intervention, they had to have had a documented success to surgical treatment intervention to stay in the study. These 56 patients were then matched with 56 control (normal) patients who had electronic thermograms. The 112 thermograms were then interpreted blindly by two thermographers. The sensitivity and specificity of thermography as a diagnostic aid in sciatica were statistically analyzed. The sensitivity of thermography (its ability to be positive when sciatica was clinically obvious) was 60% and 50% for the two thermographic readers. The specificity of thermography (its ability to be negative in asymptomatic patients) was 45% and 48% for the two thermographers. Our conclusions are no different than those published in 1985: thermography is not useful as a diagnostic aid in sciatica.

Adult↗
PubMed1986

Thermography and plethysmography in the diagnosis of deep venous thrombosis--a comparison with phlebography.

Ninety-two patients with suspected unilateral deep venous thrombosis (DVT) in the lower limb were examined by thermography, plethysmography and phlebography. ROC analysis (Receiver Operating Characteristics) was used to evaluate discrimination thresholds and to compare thermography and plethysmography (four variables) with phlebography. The sensitivity of thermography, 85% (94% for out-patients), was higher than that of plethysmography (58-79%) for the discrimination thresholds chosen. The specificity of thermography was low, 39% (42% for out-patients) or 55%, if obvious relevant clinical findings were included in the evaluation. The specificity of plethysmography was much higher (80-97%). Optimum combination of the four plethysmographic variables showed predictive values of 93-94%, while combination of thermography and plethysmographic variables showed higher predictive values (95-97%), mostly because of a higher sensitivity of thermography for distal DVT. A possible reduction of the number of phlebographic examinations by at least 50% and a cost reduction of 25% could have been obtained without any appreciable loss of diagnostic accuracy. A follow-up study of 112 consecutive patients, examined according to the recommended screening method, showed a reduction of phlebographic examinations by 62%.

Acute Disease↗
PubMed1998

Role of thermography in the diagnosis of undescended testes.

OBJECTIVES: The location of an undescended testis is important for the choice of therapy. Ultrasonography cannot serve as a stand-alone screening method in the management of the undescended testis because of its limited sensitivity and accuracy. The aim of this study was to clarify the diagnostic value of thermography in the patients with undescended testes. METHODS: We evaluated prospectively 28 patients with 36 undescended testes from January 1995 to December 1996. The patients' ages ranged from 16 to 39 months with a mean age of 26.3 +/- 8.2 months. In addition to physical palpation by a pediatric surgeon, ultrasonography and thermography were performed for screening the locations of retained testes. RESULTS: The diagnostic rates were 63.9% (23/36) by palpation, 65.7% (23/35) by ultrasonography and 54.5% (18/33) by thermography. The results of the three diagnostic methods showed no significant difference by Fisher's exact test. Of the 17 higher located testes (inguinal canal and above external ring) 7 were palpable, 8 were identified by ultrasonography, 10 were detected by thermography. Of the 7 nonpalpable testes and testes not detected by ultrasonography, 5, including 2 intra-abdominal testes, were identified by thermography. CONCLUSION: It is suggested that thermography can play a role in locating high undescended testes which are nonpalpable and not detected by ultrasonography.

Child, Preschool↗
PubMed1990

[Patho-physiological analysis on peripheral circulation using thermography as an example of functional body imaging].

The various body imaging systems can be classified into structural body imaging and functional body imaging. Thermography is a typical example of the latter category. Thermography is regarded to mainly represent peripheral circulatory function on hands and feet. We have studied the patho-physiology of peripheral circulation in normal subjects and in patients with diabetic microangiopathy, using the thermography system. Analysis of the cold loading test by thermography revealed that the recovery after cold loading was decreased with aging in healthy subjects. In diabetic patients, recovery after cold loading was apparently lower than in senile healthy subjects on foot. Thermography was also considered as a useful tool for evaluation of the effect of medicines such as PGE1, in a long-term study, as well as single dose test. Furthermore, thermography proved to be the first choice study in serious peripheral circulatory failure such as diabetic gangrene, since it is a non-invasive and non-contact examination.

Aged↗
PubMed1989

Thermography for indications other than breast lesions.

Thermography is the measurement of self-emanating infrared radiation revealing temperature variations at the body surface. The two commonly employed methods demonstrating such changes are telethermographic infrared detector/imagers and heat-sensitive cholesterolic liquid crystal systems. Both methods sense body temperature and demonstrate areas of differing heat emission by producing brightly colored patterns. Each color represents a specific temperature level. Interpretation of color patterns in dermatomes or other anatomic distributions are proposed as an aid in diagnosing and evaluating a vast array of diseases. Information obtained from the literature, responses to a Federal Register notice of this assessment, PHS agencies and medical specialty groups failed to support claims of efficacy of thermography as a useful diagnostic modality for non-breast indications. Rather, it suggested that thermography lacks sensitivity, specificity, or predictive value. Unassailable data are lacking to indicate that thermography provides a useful guide to monitor the effect of treatment of any disease entity. The evidence suggests that thermography may only confirm the presence of a temperature difference, that other procedures are needed to reach a specific diagnosis, and that thermography may add little to what physicians already know based on history, physical examination, and other studies.

Humans↗
PubMed1988

[Digital noninvasive microwave thermography in the diagnosis of breast disease].

Thermography is a noninvasive technic of examination. Liquid-Crystal Thermography and Infrared Thermography have provided great help in the general survey of breast diseases during the past twenty years but not without some limitations. Recently, by applying the microwave technic clinically, progress has been made to measure minute temperature changes in the deeper tissues. Differential diagnosis of breast disease is possible by statistical calculating the temperature difference of the two breasts. A prospective study was done in 96 women who had both X ray mammography and digital noninvasive microwave thermography. 70/96 were proved by pathology. In this group of patients, the accuracy rate was 70.00% for digital microwave thermography, 81.82% for X ray mammography and 95.50% for the two combined. The false positive rates and false negative rates, advantages, disadvantages and the for general survey of breast disease of the digital microwave thermography discussed.

Adenofibroma↗
PubMed1978

[Results of an interdisciplinary study on the value of contact thermography in the diagnosis of breast disease (author's transl)].

An interdisciplinary study was carried out to determine the accuracy of contact thermography in the detection of breast cancer. 200 patients were examined in form of a blind test, the mammographic and clinical findings being listed separately and inaccessible to the thermography team. The findings obtained on contact thermography also were listed separately and afterwards compared with the clinical and mammographic findings. 50 out of these 200 cases required histological clarification, which revealed 24 carcinomas and 26 benign conditions of the breast. Mammography and contact thermography both failed to detect 3 out of the 24 carcinomas, clinical examination gave a false negative result in 2 cases. Therefore, in the present case material, the accuracy of mammography and contact thermography is equal and enables us to state that the combination of clinical examination and contact thermography of the breast is of high accuracy and suited for routine mass screening programmes to enable the detection of breast disease without radiation exposure.

Breast Neoplasms↗
PubMed1981

Thermography in the diagnosis of DVT.

161 consecutively admitted medical patients with the clinical suspicion of acute deep venous thrombosis (DVT) were thermographed and phlebographed in order to study the congruence of these methods. The sensitivity of thermography in the detection of DVT was found to be 99%, whereas the specificity was only 49%. The low specificity is explained by the fact that all thermographs suggestive of DVT were classified as pathologic to keep the sensitivity of the method as high as possible. Patients with dilated veins which may closely resemble DVT on thermography may in these cases give false positive results. Of 76 patients with phlebographically verified DVT, 22% became thermographically normal within 22 days, whereas 78% did not normalize within the mean observation time of 31 days. In another part of the study all medical patients (101) who were residing in our wards during a period of a week were screened by means of thermography. From this unselected group 17 patients were found to have thermographs suggestive of DVT. In 5 of these patients no reason for pathological thermography could be found. Thermography is a cheap and highly sensitive screening method for DVT, but findings of false positives caused by older thromboses and dilated veins are not unusual. The frequency of such false positives may be minimized by performing thermography after exercise.

Acute Disease↗
PubMed1981

Contact plate thermography: a new technique for diagnosis of breast masses.

Ninety-four consecutive patients who underwent breast biopsy were prospectively evaluated with contact plate thermography. Final diagnosis based on surgically excised tissue was used as the standard of comparison. There were 77 benign lesions and 17 malignant lesions in the study group. A diagnosis of cancer was made by contact plate thermography in 11 of the 17 patients with malignant neoplasms, with six false-negative diagnoses. Among the 77 histologically benign lesions, contact plate thermography made the correct diagnosis in 66 cases, with 11 false-positive results. Considering all 94 patients, contact plate thermography was accurate in 81.9%, with 6.4% false-negative and 11.7% false-positive diagnoses. These data compared favorably with other diagnostic data used in this study, namely physical examination and mammography. Contact plate thermography is a quick, inexpensive, and harmless diagnostic procedure. Further evaluation of it is indicated, including its possible inclusion in breast cancer screening programs.

Adenocarcinoma↗
PubMed1977

Present status of thermography, ultrasound and mammography in breast cancer detection.

Various biophysical methods have been utilized in the diagnosis of breast cancer. To date the best results have been obtained with x-ray mammography. Ultrasound and thermography have great appeal as non-destructive techniques but, in the present state of development, are of limited use. The spatial resolution presently obtainable in ultrasonograms is inadequate for the detection of subclinical cancer and thermography is also of questionable reliability. While an overall true positive rate of 70% to 75% may be anticipated with thermography, the bulk of false negatives would seem to occur in those tumors most amenable to therapy, i.e., subclinical cancers. The "false positive" rate of thermography is also excessive, but would be acceptable for establishing a high risk group if true positive rates could be improved. At present thermography finds its greatest use as an adjunct to mammography and physical examination; it should not be used as the sole modality in a screening program. The efficacy of mammography can be readily demonstrated but the propriety of its use as a screening device has been questioned. This is primarily related to the possible carcinogenic effect of radiation at diagnostic levels. Although the carcinogenic effect is unproven, the dose in radiologic procedures should be kept to a minimum consistent with adequate images. The present state of the art would indicate that the risk, if any, is minimal as contrasted with the natural incidence of breast cancer and the results of early diagnosis and treatment.

Adult↗
PubMed1987

Application of thermography to the evaluation of the histamine skin test in man.

The degree of skin flare 10 min after intradermal injection of histamine (0.06-2 micrograms in 0.1 ml saline) was evaluated both visually and by thermography in 6 healthy male volunteers. Intradermally injected histamine increased the skin flare area in a dose-dependent manner. There was a good exponential correlation (r = 0.963) between the flare area evaluated visually and that evaluated by thermography, indicating that the degree of underestimation of the flare area by visual inspection increased with increasing flare size. This could be due to the fact that the rather irregular shape of a flare was rounded by the eyes. Suppressive effects of an antihistamine, terfenadine (20, 40, 60, and 120 mg, p.o.), on the flare caused by histamine (2 micrograms/0.1 ml saline) were evaluated in a similar way in a single-blind, crossover controlled trial using 15 healthy male volunteers. The histamine skin test was evaluated both visually and by thermography before and 4 hr after administration of placebo or each of 4 doses of terfenadine. Terfenadine (20, 40, and 60 mg) suppressed the skin flare in a dose-dependent manner, but 60 and 120 mg had almost the same effect. In all cases the flare area evaluated visually was smaller than that obtained by the thermography, although the degrees of reduction of flare area by the drug were similar by both methods when expressed as a percentage of placebo. In conclusion, thermography could serve as a tool for the objective evaluation of the histamine skin test.

Adult↗
PubMed2004

Can infrared thermography be a diagnostic tool for arthralgia of the temporomandibular joint?

This paper presents a review of the use of infrared thermography in diagnosis of temporomandibular joint (TMJ) arthralgia. The question examined was whether the infrared thermography could be reliably used as a tool to diagnose arthralgia by objectively assessing the site of origin and the degree of irritation. Controlled studies were performed by using advanced thermographic devices to show both diagnostic validity and reliability of infrared thermography as a screening test for selecting healthy subjects from patients with unilateral TMJ arthralgia. The study revealed that thermography fails to meet the criteria of high level of evidence. Further studies are required to confirm these results in order to specify analysis of facial thermal patterns and to better understand the relationship between TMJ arthralgia and regional temperature changes. Until then infrared thermography cannot be recommended for routine use as a diagnostic technique to identify TMJ disorders.

Arthralgia↗
PubMed2003

Evaluation of provocation test monitoring palmoplantar temperature with the use of thermography for diagnosis of focal tonsillar infection in palmoplantar pustulosis.

BACKGROUND: Since focal tonsillar infections are often associated with palmoplantar pustulosis (PPP), provocation tests have been performed for preoperative evaluation of tonsillectomy. However, these tests have not been fully established. OBJECTIVES: To introduce a more sensitive operative indication for tonsillectomy to the patients with PPP, we have monitored the temperature after provocation tests at palmoplantar sites, as measured by thermography, and we hypothesized that this methodology may lead to a more sensitive marker for tonsillectomy. METHODS: Twenty-two PPP patients with/without clinical tonsillitis were included in this study. After mechanical tonsillar massage, using infrared thermography, we have monitored the surface temperature at palmoplantar sites of 22 patients with PPP, five chronic tonsillitis patients without PPP, and four healthy controls, to compare the findings with the skin lesional outcome after tonsillectomy. RESULTS: There was a significant relationship between the effects of tonsillectomy and the results of provocation tests assessed by thermography. The sensitivity, specificity, and efficiency of the provocation tests with thermography of detecting a favorable outcome of tonsillectomy were 75.0, 83.3, and 77.3%, respectively, while those of the provocation tests as estimated with the conventional criteria were 37.5, 83.3, and 50.0%, respectively. CONCLUSION: Our results suggest that a new indicator using non-invasive thermography for the provocation tests is useful in predicting the effects of tonsillectomy for PPP.

Adult↗
PubMed2005

Investigations of single and multilayer structures using lock-in thermography--possible applications.

This paper presents a study of the possibilities of evaluating thermal parameters of single and multilayer structures using dynamic thermography. It also discusses potential uses of lock-in thermography. It presents a simulation of a periodic excitation of a multilayer composite material. In practice, the described methods can be employed in various applications, for example, in multilayer nonwoven microelectronic components manufactured from hemp fibers, chemical fibers, with an addition of electrically conducting fibers, and in medicine and biology. This paper describes tests conducted with lock-in thermography on carbon fibre reinforced composites with implanted delamination defects. Lock-in thermography is a versatile tool for non-destructive evaluation (NDE). Lock-in thermography is a fast, remote and non-destructive procedure. Hence, it has been used to detect delaminations in the composite structure of aircraft. This method directly contributes to an improvement in safety.

Aircraft↗
PubMed1975

Thermography.

As thermographic equipment is improved and as physicians gain experience in its use, thermography gradually is gaining importance as a diagnostic aid in a wide range of disease processes. The technic is finding increasing acceptance in diagnosis of breast disease particularly as an adjunct to mammography. The American Cancer Society and the National Cancer Institute are in the process of establishing 20 demonstration centers for breast cancer detection using thermography, mammography, and physical examinations. Although all of the centers are not at present fully staffed with personnel experienced in thermographic interpretation, the project promises to give a better basis for cost estimates for screening with the thermography as compared to present systems. The technologic knowledge exists for the development of improved scanning infrared cameras with magnetic tape storage and dynamic display. These systems will lend themselves to quantitative measurements and semiautomatic interpretation which can improve the accuracy and reduce the cost of mass screening for breast cancer. Although additional clinical research is necessary, thermography has numerous applications in a variety of disease states. In the future, total body thermography may well become an important part of medical screening examinations.

Arthritis, Rheumatoid↗
PubMed2006

Assessment of culprit plaque temperature by intracoronary thermography appears inconclusive in patients with acute coronary syndromes.

OBJECTIVE: Safety and feasibility evaluation of intracoronary temperature measurements in patients with acute coronary syndromes (ACS) using a catheter based thermography system. METHODS AND RESULTS: Thermography was performed in 40 patients with ACS. A 3.5-F thermography catheter containing 5 thermocouples measuring vessel wall temperature, and 1 thermocouple measuring blood temperature (accuracy 0.05 degrees C) was used. Gradient (deltaTmax) between blood temperature (T(bl)) and the maximum wall temperature during pullback was measured. The device showed satisfactory safety in ACS. Only in 16 patients (40%) deltaTmax was > or = 0.1 degrees C. In 23 patients (57.5%) the highest deltaTmax was found in the culprit segment. DeltaTmax between culprit and adjacent non-culprit segments was observed in patients with transient blood flow interruption during thermography (0.11+/-0.03 versus 0.08+/-0.01; P=0.04), in contrast to patients with preserved flow (0.07+/-0.03 versus 0.06+/-0.02; P=0.058). CONCLUSIONS: The novel, technically sophisticated intracoronary thermography proved its safety and feasibility. However, we were not able to convincingly and consistently differentiate between different lesions at risk, despite a selection of lesions that should appear most distinct to differentiate. A systematic interruption of flow may be necessary to achieve diagnostic results consistently, although such requirement may unfavorably change the risk-to-benefit ratio of this developing technology.

Aged↗
PubMed1975

The significance of thermography in the diagnosis of acute abdominal disease.

Thermography appears to be a useful supporting aid to classical methods of examination in the clarification of the problems of acute abdominal disease. In a study of 100 patients thermography was in support of the true diagnosis in acute appendicitis in 63 per cent, in acute biliary tract disease in 59 per cent, and, in an attempt to differentiate between tumor and periappendicular abscess, assistance was rendered by thermography in 53 per cent of patients. However, some uncertainty exists because carcinoma often produces in its environment an inflammatory reaction, which causes an increase of temperature visible in the thermogram. In the present series thermography produced a finding supporting the correct diagnosis in 59 per cent. Errors occurred most often in obese patients, who have thick abdominal covers. Thermography also has an obvious application in the localizing of postoperative suppurative foci.

Abdomen, Acute↗