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PubMed1978

Thermography in screening postoperative deep vein thrombosis: a comparison with the 125I-fibrinogen test.

The value of thermography as a screening method for postoperative deep vein thrombosis has been evaluated in 308 patients (616 legs). Comparison was made with the 125I-fibrinogen test. The overall diagnostic agreement was 81.0 per cent; the sensitivity was 62.1 per cent and the specificity 90.3 per cent. The agreement increased with proximal extension of the thrombi. Thermography became positive 0.26 days after the 125I-fibrinogen test but in 19.8 per cent thermography was positive before a positive fibrinogen test.

Aged↗
PubMed2006

Noninvasive magnetic resonance thermography of soft tissue sarcomas during regional hyperthermia: correlation with response and direct thermometry.

BACKGROUND: The objective of this study was to evaluate noninvasive magnetic resonance (MR) thermography for the monitoring of regional hyperthermia (RHT) in patients with soft tissue sarcomas of the lower extremities and pelvis. METHODS: Noninvasive MR monitoring during RHT was performed in 9 patients who had high-risk soft tissue sarcomas of the lower extremities or pelvis during neoadjuvant chemotherapy plus RHT in the scope of the European Organization for Research and Treatment of Cancer 62961/European Society for Hyperthermic Oncology RHT-95 study. Anatomic and temperature-sensitive data sets were acquired every 10 minutes before and during RHT (using gradient-echo-sequences with variable echo times). MR temperature distributions were derived from the phase differences by using the proton-resonance frequency shift method. A phase convolution setting phase shifts to zero in the fat tissue was performed as a drift correction. The mean MR temperatures in the tumor and muscles and the index temperatures (e.g., T90, which covers 90% of the target volume) and thermal doses were determined and compared with pathohistologic responses and direct temperature measurements if available. RESULTS: Thirty of 72 MR-thermography data sets (>40% of heat sessions) were evaluable. A significant correlation was observed between pathohistologic response (defined as a necrosis rate >or=90%) and standardized thermal parameters, such as thermal dose cumulative equivalent minutes at 43 degrees C to 90% of the target volume (T90) (P = .050), mean T90 (P = .048), or T50 (P = .050). The correlation of 13 conventional temperature measurements performed in selected patients and sessions invasively in the tumor or noninvasively in rectum and bladder revealed an excellent correlation with MR temperatures (R2 = .96). CONCLUSIONS: Noninvasive MR thermography of soft tissue sarcoma was feasible and suitable for validating the quality of heating during RHT.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Thermography: a reevaluation.

This is a brief review of the physical and physiologic aspects and theories of thermography and its clinical use in musculoskeletal conditions. Thermography is a simple, non-invasive procedure with a potential for usefulness. However, the majority of clinical studies to date have not been performed independent of other examinations with controlled verification, nor are there standards of normal available for comparison. Thermography should not be offered to the public as a confirmed and reliable tool for the diagnosis and management of musculoskeletal problems. It is still experimental, and its clinical use cannot be justified until appropriate data support it.

Autonomic Nervous System↗
PubMed1994

Microwave thermography as a noninvasive assessment of disease activity in inflammatory arthritis.

Microwave thermography is the technique of measuring natural thermal radiation from body tissues of clinical interest. It is safe, requires no control of environmental conditions and exposes the patient to no ionising radiation. In this study, we found that microwave thermography of the knee joints showed weak correlation with some global parameters of disease activity. Bed rest alone for three days had no significant effect on microwave thermographic index (MTI). Intra-articular steroid injection, however, was associated with a marked fall in MTI both in the injected knee and the contra-lateral knee. We conclude that microwave thermography can measure inflammatory activity in the knee joints of patients with inflammatory arthritis and can respond to clinical change brought about by major treatment intervention.

Adrenal Cortex Hormones↗
PubMed2003

Intracoronary thermography.

Arteriosclerosis is an inflammatory disease. Inflammatory processes play a role in the initiation of plaque development and the early stages of the disease as well as in complex plaques and complications such as intraarterial thrombosis. A method to detect inflammation in coronary arteries has the potential to characterize both local and systemic activation of arteriosclerotic plaque disease. It could help to define in more detail what constitutes a vulnerable plaque or vulnerable vessel and thus improve the prediction of acute coronary syndromes. Intracoronary thermography records a cardinal sign of inflammation. Heat is probably produced by (activated) macrophages. Experimental work has suggested that thermal heterogeneity is present in arteriosclerotic plaques and that increased temperature is found at the site of inflammatory cellular-macrophage-infiltration. Preliminary experience in patients undergoing coronary angiography has demonstrated that it is safe and feasible to perform intracoronary thermography using various systems. A graded relationship between thermal heterogeneity and clinical symptoms has been reported, with the greatest temperature elevation in acute myocardial infarction. Increases in thermal heterogeneity appeared to be associated with a comparably unfavorable long-term prognosis. Intracoronary thermography has the potential to provide insights into location and extent of inflammation as well as the prognostic consequences. Currently, this novel method and the underlying concepts are extensively evaluated.

Aged↗
PubMed2000

Dynamic thermography of the knee joints in rheumatoid arthritis (RA) in the course of the first therapy of the patient with methylprednisolone.

Thermography in rheumatology is most often used in a static manner: after having fulfilled the conditions of standardized preparation of the patient in a cold examination room one or more thermograms are taken in standard positions for the respective joints. In our hospital the thermograms are more or less supplementary. The main examination result is a rewarming curve of the skin over the knee joints. The rewarming is provoked by dry cooling of the skin for one minute. Calculation of the slope of the rewarming curve and plotting the slope on a logarithmic scale shows two different rewarming processes in the skin overlying inflamed joints. The faster one is the rewarming by the arterial blood flow in the skin and the slower one is an additional rewarming by a pathological venous skin blood flow originating from deeper tissues under the skin. One has to suppose that the occurrence of excessive nitric oxide production in inflamed tissues is responsible for this pathological venous skin blood flow. Until now only nine patients receiving for the first time methylprednisolone could be included in a therapy study. Therefore only slight indications can be seen in the results. Whereas the erythrocyte sedimentation rate (ESR [mm/h] becomes more homogeneous (lower confidence interval CI 95) over the course of the treatment with decreasing drug dose, the thermal signs of inflammatory activity as measured by dynamic thermography have greater CI 95 values at the end than at the beginning of the treatment under study. This indicates that not all patients had sufficient antiinflammatory medication with the final 6 mg/d of methylprednisolone as measured by dynamic thermography but not by ESR or CRP.

Arthritis, Rheumatoid↗
PubMed2003

Real-time thermography during energized vessel sealing and dissection.

BACKGROUND: Energized dissection systems facilitate laparoscopic dissection and hemostasis and reduce instrument traffic. However, they can introduce undesirable thermal collateral/proximity damage to adjacent structures mainly by heat conduction, although other mechanisms may be involved. The latest generation devices have the potential to reduce the incidence of such problems through use of active feedback control over the power output. This effectively regulates the delivery of energy to the target tissue with minimal thermal collateral damage. In addition, innovative heat-sink engineering of the device head ensures that the surface of the instrument tip remains cool (<45 degrees C). In this study, we evaluated the performance of this technology (LigaSure) by using dynamic infrared thermography. The thermal imaging measurements were then correlated with histopathologic studies. The overall value of in situ thermography as an adjunct to energized surgical dissection systems was also assessed. METHODS: Eight anesthetized pigs underwent open surgery to mobilize eight target vessels/organs in a randomized fashion. The LigaSure vessel sealing system with Instant Response Technology was used with three different interchangeable heads. In situ dynamic thermography was undertaken with a thermal imaging camera operating in the mid-infrared (3-5 microm) waveband and with each fully digitized 12-bit thermographic frame acquired at a rate of 60 Hz. Following sacrifice at the end of the dissection, tissue from the dissected regions was harvested for histology by an independent pathologist who was blinded to the thermographic data. RESULTS: Seals made with both the LS1000 5-mm laparoscopic head (predominantly to the small bowel and colon) and the LS1100 10-mm (Atlas) device (on the liver and short gastric tissues) were outwardly satisfactory. The average thermal spread [see text] with the LS1000 was = [see text] 4.4 mm, and the exposed surface of the instrument tip developed a temperature of approximately 100 degrees C. This instrument thus has the potential, albeit small, for heat-related proximity iatrogenic injury. The more technologically advanced LS1100 10-mm laparoscopic instrument exhibited a superior performance, with [see text] = 1.8 mm, and with a maximal temperature on the exposed surface of the jaws well within tolerable limits (approximately 35 degrees C) for use during surgery (laparoscopic or open). This was confirmed by histological studies that demonstrated negligible evidence of thermal damage. CONCLUSIONS: In situ thermal imaging represents a powerful modality for the monitoring of energized dissection/coagulation during surgery. The LigaSure system used with the LS1100 head constitutes a very safe option for energized dissection and hemostasis of vessels with a diameter of up to approximately 7 mm.

Animals↗
PubMed1983

Thermography and oral inflammatory conditions.

A brief review of the literature on the use of thermography in medicine and dentistry is presented. This is followed by the presentation of eleven case reports of the use of thermography in dental clinic patients with various oral inflammatory conditions. The results showed that in seven of the eleven cases the thermogram was able to delineate the involved from the noninvolved side. The findings were nonspecific, however, and in its current form thermography cannot be used alone for differential diagnosis.

Cellulitis↗
PubMed1989

Electronic thermography in the diagnosis of atypical odontalgia: a pilot study.

Atypical odontalgia (AO) is a dental condition that is usually diagnosed by exclusion after failure of multiple dental treatments. A functional definition of AO includes (1) continuous pain in and about a tooth or teeth, (2) pain present for longer than 4 months, (3) inadequate local cause (no abnormality detected on dental radiographs), and (4) anesthetic blockade gives equivocal relief of toothache. The purpose of this study was to assess the potential role of electronic thermography in the diagnosis of AO. Results from measurements of facial thermal symmetry indicated that normal subjects = 83.5%, AO group = 65.8% (p less than 0.01). Electronic thermography interpreted by thermography experts has promise as a diagnostic test for AO among patients with toothache for which the dentist can find no convincing dental explanation.

Adult↗
PubMed2004

Intravascular thermography: Immediate functional and morphological vascular findings.

AIMS: To investigate safety, feasibility, and injurious effect on endothelial cells of a thermography catheter as well as effect of flow on measured temperature in non-obstructive arteries. METHODS AND RESULTS: Safety and feasibility were tested in both rabbit aortas and pig coronary arteries. Evaluation of endothelial damage by the catheter (acute, 7 and 14 days) was performed in pig coronaries using Evans Blue, scanning electron microscopy (SEM) and Factor-VIII antibody and compared with normal arteries and arteries that underwent intravascular ultrasound (IVUS). The effect of flow on temperature heterogeneity was analysed both in vitro and in vivo conditions. All procedures were successful without any adverse events; intra- and inter-operator variability was low. Intracoronary use of the catheter was associated with acute but reversible de-endothelialization, paralleling the findings associated with IVUS use. Changes in flow velocities under physiologic flow conditions did not significantly influence the temperature differences measured both in vitro and in vivo; temperature heterogeneity was more pronounced in absence of flow. CONCLUSIONS: Intracoronary thermography using a dedicated catheter is safe and feasible with a similar degree of de-endothelialization as IVUS. Temperature heterogeneity remained unchanged under normal physiologic flow conditions allowing clinical use of thermography.

Animals↗
PubMed1997

Use of high-speed, high-resolution thermography to evaluate the tear film layer.

PURPOSE: To evaluate the tear film layer in patients with dry eye and in normal subjects by measuring the corneal temperature with infrared radiation thermography. METHODS: One eye of each of 13 patients with dry eye and one eye of each of seven normal subjects were evaluated randomly. The corneal temperature was measured continuously with a recently improved infrared radiation thermography technique. We calculated the k value, which reflected the steepness of the corneal temperature change. The bigger the k value was, the more rapid was the decrease in corneal temperature, and this was directly related to increased evaporation. RESULTS: With normal blinking, the mean k value for patients with dry eye (5.6 +/- 2.9 per second) was significantly less than that in the control subjects (9.3 +/- 5.0 per second; P < .05). Keeping the eyes open after closing the eyes significantly decreased the k values compared with normal blinking in both groups (P < .05). CONCLUSIONS: Our findings demonstrate the usefulness of this method of measuring corneal temperature to evaluate the tear film layer. High-speed, high-resolution thermography detected subtle changes in corneal temperature with enhanced sensitivity and spatial and temporal resolution. We found that the mean k value, and therefore the rate of decline in corneal temperature in patients with dry eye, was significantly less than that in normal subjects. The k value may therefore reflect tear film layer stability. The measurement of the changes in the corneal temperature can thus give us valuable information on the tear film layer.

Adult↗
PubMed1976

The value of scrotal thermography as compared with selective retrograde venography of the internal spermatic vein for the diagnosis of "subclinical" varicocele.

The accuracy of scrotal thermography as a diagnostic method to confirm or detect spermatic venous reflux in patients with palpable and subclinical varicocele, respectively, was evaluated. In all, 118 scrotal thermograms were performed in 110 patients, and the results were compared with the findings by selective retrograde venography of the internal spermatic vein whenever required. Normal thermograms were recorded in 23 oligospermic men without varicocele. Of 39 patients with palpable varicocele, 37 had abnormal thermograms; normal recordings occurred in 2 patients with associated unilateral testicular atrophy. Among 36 men suspected of having subclinical varicocele, 19 had abnormal thermograms and 16 presented reflux on the venogram. Venography was performed in 5 of the remaining 17 men with normal thermograms; only 1 had reflux. Screening for varicocele by means of scrotal thermography thus revealed reflux in 16 of 36 patients with unexplained infertility. Postoperative thermograms were disturbed in 6 of 20 cases, 5 of which presented reflux. Only 1 of 14 postoperative patients with normal thermograms underwent venography, and no reflux was demonstrable. Both the difference in temperature between the affected and contralateral hemiscrotum and the area of hyperthermia were significantly greater in patients with grades II and III varicocele, compared with those with subclinical and grade I varicocele. It is concluded that scrotal thermography is a valuable screening method for the detection of spermatic venous reflux. The technique allows selection of patients to be subjected to retrograde venography.

Adult↗
PubMed1985

Liquid crystal thermography as a screening test for deep-vein thrombosis.

The accuracy of liquid crystal colour thermography and clinical examination was compared with that of X-ray venography in 80 patients clinically suspected of having unilateral, lower-limb, deep-vein thrombosis. The clinical examination was not helpful in diagnosis. Of the 35 patients with confirmed deep-vein thrombosis, 34 had a positive thermogram, giving a sensitivity of 97%. 17 false-positive thermograms gave a specificity of 62%. The predictive value of a negative thermogram was 96.5%. Liquid crystal colour thermography is a quick, inexpensive, non-invasive investigation that might be useful as a screening test in patients suspected of having unilateral, lower-limb, deep-vein thrombosis. A diagnostic scheme starting with liquid crystal thermography and followed by 99mTc venoscanning might obviate the need for X-ray venography in almost 80% of patients with suspected deep-vein thrombosis.

Adolescent↗
PubMed1987

Thermography in the detection of carpal tunnel syndrome and other compressive neuropathies.

Studies were conducted using liquid crystal thermography (FlexiTherm) and electronic thermography for the diagnosis of carpal tunnel syndrome. Studies were also conducted to differentiate carpal tunnel syndrome from peripheral neurovascular injuries. Ninety patients were included in the study, with an average follow-up time of 24 months. Fifty patients also had electric studies for comparison and contrast. Thermal patterns of carpal tunnel syndrome showed a decreased vascular heat emission pattern over the median nerve distribution. The procedures using thermography consisted of imaging of the cervical spine, shoulders, forearms, and hands by Wexlerian guidelines to obtain diagnostic thermograms and a stress series. Results of the studies showed that thermographic studies were efficacious and sensitive for the differential diagnosis of carpal tunnel syndrome from other peripheral compressive neuropathies, including cervical radiculitis, thoracic outlet syndrome, cubital tunnel syndrome, and Guyon's canal syndrome. Biomechanic and etiologic factors indict carpal tunnel syndrome to be an occupational disease. Thermographic technique use may lead to the early diagnosis, treatment, and preventative measures that could eliminate the high cost of manpower loss and of medical care often concomitant with carpal tunnel syndrome.

Adult↗
PubMed1995

Electronic thermography for the assessment of mild and moderate temporomandibular joint dysfunction.

Today facial heat emission patterns may be rapidly obtained and quantified with the use of advanced electronic thermography units that have the promise of being a nonionizing, noninvasive, low-cost diagnostic alternative for the evaluation of temporomandibular joint disorders. This study design measured the use of electronic thermography as a tool to select between asymptomatic (control) subjects and a patient group with mild to moderate temporomandibular joint disorders. Study populations consisted of 24 asymptomatic (control) subjects and 20 patients with (1) either locked or unlocked temporomandibular joints, (2) varying degrees of limitation of mouth opening, (3) mild to moderate muscle pain, and (4) mild to moderate temporomandibular joint arthralgia. The results indicated that the control group demonstrated a high level of thermal symmetry over the temporomandibular joint region. The patient group demonstrated a low level of thermal symmetry with a delta T value of 0.4 degrees C. The control group was selected from the patient group with 85% sensitivity (17 of 20), and 92% specificity (22 of 24), and 89% overall accuracy (39 of 44), when selecting among the 44 subjects used in this study. The conclusion therefore is that electronic thermography shows promise as a method of diagnosing mild to moderate temporomandibular joint disorders.

Adult↗
PubMed2002

[Effect of extracorporeal shockwave therapy on vascular regulation. Infrared thermography in epicondylitis humeri radialis].

BACKGROUND: Extracorporeal shockwave therapy (ESWT) is recommended as an alternative treatment for lateral epicondylitis (LE). An influence on the blood perfusion is considered to be one possible effect. Infrared thermography is used in this trial to measure effects of ESWT on the thermal regulation in the target area. METHODS: 33 patients with chronic LE were examined in a prospective, placebo-controlled single blind study with an independent observer. 3 x 2000 impulses of an energy flux density ED+ 0.22 mJ/mm2 were applied under local anaesthesia as verum-ESWT. Placebo-ESWT was performed under the same conditions. One elbow was treated, the other served as control. Before and after each shockwave application and after 12 weeks skin temperature was measured on both elbows at three predefined points by infrared thermography. RESULTS: While a significant decrease in the skin temperature was found on the treated and sham-treated sides opposed to the contralateral side, there was no difference between the real shockwave treatment and placebo therapy. Responder and Non-responder to the treatment could not be distinguished during the therapy. DISCUSSION: Infrared thermography was proved to be a valuable additional technical instrument for diagnosis of LE, but is not an appropriate instrument to predict the clinical outcome in patients treated with ESWT. A noted reduction of skin temperature on the treated side is not due to specific effects of the shockwaves. It is unlikely that ESWT as applied has an influence on thermal regulation in the target area. These findings are supported by negative results of experimental and clinical trials.

Adult↗
PubMed2002

Use of infrared thermography to detect injections and palmar digital neurectomy in horses.

Thermography is a non-contact, non-invasive technique that detects surface heat emitted as infrared radiation. Because skin temperature reflects the status of underlying tissue metabolism and blood circulation, abnormal thermal patterns can signify areas of superficial inflammation. The objective of this study was to determine if thermography could detect the injection of analgesic and neurolytic agents and surgical palmar digital neurectomy. Procedures evaluated include injection of the lumbar region, suspensory ligaments, tibial nerve, palmar digital nerves, and palmar digital neurectomy. Thermographic images were obtained before and after the procedures until a significant difference was no longer detected. Local injection of the lumbar region and the suspensory ligament produced detectable thermal patterns for two days, and tibial nerve infiltration with a neurolytic agent was significant for two days. Analgesia of the palmar nerves was significant for 24h with bupivicaine, compared to five days for ammonium chloride. Palmar digital neurectomy produced more variable thermal patterns. While sensitive enough to detect changes in heat patterns from control regions, thermography is not specific enough to discriminate between procedures and injury inducing an inflammatory response.

Analgesia↗
PubMed1988

[Tele-thermography in the diagnosis of deep leg and pelvic venous thrombosis].

The results of thermography were compared with those of phlebography in 235 patients with suspected deep venous thrombosis in the legs. Any thermal difference between the two sides was regarded as abnormal. On this basis, thermography had a sensitivity of 97%. Thermography is therefore a reliable, simple, non-invasive and repeatable examination for the exclusion of leg vein thrombosis.

Adult↗