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    Application of infrared thermography in the early warning of pressure injury: A prospective observational study. Cai Fuman,Jiang Xiaoqiong,Hou Xiangqing,Wang Duolao,Wang Yu,Deng Haisong,Guo Hailei,Wang Haishuang,Li Xiaomei Journal of clinical nursing AIMS AND OBJECTIVES:To verify the ability of infrared thermography in objectively identifying pressure injury and its application value in the early warning of pressure injury. BACKGROUND:There is subjectivity in assessing the risk of pressure injury as well as diagnosis in clinical settings, which makes early detection and prevention difficult. DESIGN:Prospective, cohort study. METHOD:Four hundred and fifteen patients admitted to the adult intensive care units were enrolled by a convenience sampling method, and they received a follow-up monitoring for 10 days. The risk of pressure injury was assessed via Braden scale, and thermal images of sacral area were obtained by infrared thermal imager once a day. The predictive effects of infrared thermography and Braden scale on pressure injury were compared by the receiver operating characteristic curve from which the optimal cut-off value of skin temperature for predicting pressure injury was determined. The effect of skin temperature on pressure injury was described and compared, using Kaplan-Meier curve and Cox proportional hazard regression model, respectively. We followed STROBE checklist for reporting the study. RESULTS:The relative temperature of sacral area was negatively correlated with the risk of pressure injury. The efficiency of infrared thermography for diagnosing pressure injury was better than that of Braden scale. Based on the relative temperature optimal cut-off value (-0.1°C), Kaplan-Meier curve and Cox proportional hazard regression model analysis showed the incidence of pressure injury with relative temperature below -0.1°C was higher than the group with relative temperature above -0.1°C. CONCLUSIONS:Infrared thermography can objectively and accurately identify local hypothermia warnings of pressure injury before visual recognition. The application of infrared thermography into routine pressure injury risk assessment provides a timely and reliable method for nursing practitioners. RELEVANCE TO CLINICAL PRACTICE:Infrared thermography has great value of clinical application in daily pressure injury assessment. It is of great significance to make a faster and more objective clinical judgement for patients at risk of pressure injury. 10.1111/jocn.15576
    Infrared thermography assessment of patients with temporomandibular disorders. Barbosa J S,Amorim Amam,Arruda Mjalla,Medeiros Gbs,Freitas Aplf,Vieira Lem,Melo D P,Bento P M Dento maxillo facial radiology OBJECTIVES:To assess patients with and without temporomandibular disorders (TMD) infrared thermography according to the differences in thermal radiance using quantitative sensitivity and specificity tests; and to evaluate the thermal asymmetry and the correlation of the thermal intensity with the intensity of pain upon palpation. METHODS:This cross-sectional study performed a quantitative evaluation of clinical and thermographic examinations. The volunteers were evaluated for the presence of TMD using RDC/TMD (Diagnostic Research Criteria for Temporomandibular Disorders), and were divided into two groups: TMD group ( = 45); control group ( = 41), composed of volunteers without TMD, according to the Fonseca Anamnestic Index. The images were assessed for selected regions of interest for the masseter, anterior temporal and TMJ muscles. The mean values ​​of the areas of both groups were compared under the receiver operating characteristic curve. Spearman correlation analysis (non-parametric data) between pain level and mean temperature, by region, and the Pearson's χ test was used to verify the association between the presence of temperature and pain asymmetry. The level of significance was set at < 0.05. RESULTS:Both Groups, with and without TMD, presented with absolute and non-dimensional mean temperature without statistical differences (>0.05). When correlating temperature with intensity of pain upon palpation, a negative correlation was observed for the masseter muscle. CONCLUSION:Infrared Thermography resulted in low area under the curve, making it difficult to differentiate TMD via thermographic analysis. The intensity of pain upon palpation in patients with TMD may be accompanied by a decrease in local temperature. 10.1259/dmfr.20190392
    Computer aided diagnosis of diabetic foot using infrared thermography: A review. Adam Muhammad,Ng Eddie Y K,Tan Jen Hong,Heng Marabelle L,Tong Jasper W K,Acharya U Rajendra Computers in biology and medicine Diabetes mellitus (DM) is a chronic metabolic disorder that requires regular medical care to prevent severe complications. The elevated blood glucose level affects the eyes, blood vessels, nerves, heart, and kidneys after the onset. The affected blood vessels (usually due to atherosclerosis) may lead to insufficient blood circulation particularly in the lower extremities and nerve damage (neuropathy), which can result in serious foot complications. Hence, an early detection and treatment can prevent foot complications such as ulcerations and amputations. Clinicians often assess the diabetic foot for sensory deficits with clinical tools, and the resulting foot severity is often manually evaluated. The infrared thermography is a fast, nonintrusive and non-contact method which allows the visualization of foot plantar temperature distribution. Several studies have proposed infrared thermography-based computer aided diagnosis (CAD) methods for diabetic foot. Among them, the asymmetric temperature analysis method is more superior, as it is easy to implement, and yielded satisfactory results in most of the studies. In this paper, the diabetic foot, its pathophysiology, conventional assessments methods, infrared thermography and the different infrared thermography-based CAD analysis methods are reviewed. 10.1016/j.compbiomed.2017.10.030
    Infrared (IR) thermography as a potential screening modality for carotid artery stenosis. Saxena Ashish,Ng E Y K,Lim Soo Teik Computers in biology and medicine In the present study, an infrared (IR) thermal camera was used to map the temperature of the target skin surface, and the resulting thermal image was evaluated for the presence of carotid artery stenosis (CAS). In the presence of stenosis in the carotid artery, abnormal temperature maps are expected to occur on the external skin surface, which could be captured and quantified using IR thermography. A Duplex Ultrasound (DUS) examination was used to establish the ground truth. In each patient, the background-subtracted thermal image, referred to as full thermal image, was used to extract novel parametric cold thermal feature images. From these images, statistical features, viz., correlation, energy, homogeneity, contrast, entropy, mean, standard deviation (SD), skewness, and kurtosis, were calculated and the two groups of patients (control and diseased: a total of 80 carotid artery samples) were classified. Both cut-off value- and support vector machine (SVM)-based binary classification models were tested. While the cut-off value classification model resulted in a moderate performance (70% accurate), SVM was found to have classified the patients with high accuracy (92% or higher). This preliminary study suggests the potential of IR thermography as a possible screening tool for CAS patients. 10.1016/j.compbiomed.2019.103419
    Infrared thermography to assess dermatomal levels of labor epidural analgesia with 1 mg/mL ropivacaine plus 0.5 µg/mL sufentanil: a prospective cohort study. Bouvet L,Roukhomovsky M,Desgranges F-P,Allaouchiche B,Chassard D International journal of obstetric anesthesia BACKGROUND:Assessment of the effectiveness of obstetric epidural analgesia may be difficult and techniques for objective assessment of epidural spread of local anesthetic would be useful. In this prospective cohort study we assessed whether obstetric epidural analgesia from a low concentration of ropivacaine led to significant change in cutaneous temperature, related to sympathetic block detected by infrared thermography, at dermatomes C4, T4, T10, L2 and L5. METHODS:Women in spontaneous labor who requested epidural analgesia were consecutively recruited. Epidural analgesia was induced with a bolus of 10-15 mL of ropivacaine 1 mg/mL and sufentanil 0.5 µg/mL, followed by continuous epidural infusion. Skin temperature was measured using thermography before and 20 min after the epidural bolus. The verbal pain score using a numeric rating scale was recorded before and 60 min after the epidural bolus. The upper sensory block to cold sensation was tested 30 and 60 min after the bolus by a physician blinded to the skin temperature. Failed epidural analgesia was defined as verbal pain score >3 at 60 min. RESULTS:Fifty-three parturients were included and analyzed. We found a significant increase in skin temperatures measured at T4, T10, L2 and L5 dermatomes, but not at C4, and a significant difference in the change in skin temperature at T10 between failed (n=3) and successful (n=50) epidural analgesia. CONCLUSIONS:These results suggest that infrared thermography might be useful for the early diagnosis of successful obstetric epidural analgesia. 10.1016/j.ijoa.2019.08.006
    [A preliminary study on the diagnostic value of infrared thermography in children with idiopathic thrombocytopenic purpura]. Mi Baohong,Yu Cunguo,Song Jialin,Hong Wenxue,Zhang Wenzheng,Wang Yue Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi Idiopathic thrombocytopenic purpura (ITP) is a common bloody disease with a high incidence in children, but its diagnostic method is exclusive diagnosis, and the existing detection techniques are mostly invasive, which may cause secondary injury to patients and also may increase the risk of disease. In order to make up for the lack of the detection method, this study made a preliminary exploration on the diagnosis of children's ITP from the perspective of infrared thermography. In this study, a total of 11 healthy children and 22 ITP children's frontal infrared thermal images were collected, and the pattern characteristic (PFD), average temperature (Troi) and maximum temperature (MAX) characteristics of 7 target areas were extracted. The weighted PFD parameters were correlated with the platelet count commonly used in clinical diagnosis, and the sensitivity and specificity of the weighted PFD parameters for children's ITP were calculated through the receiver operating characteristic curve (ROC). The final results showed that the difference of the weighted PFD parameters between healthy children and ITP children was statistically significant, and the parameters negatively correlated with platelet count. Under the ROC curve, the area under the curve (AUC) of this parameter is as high as 92.1%. Based on the research results of this paper, infrared thermography can clearly show the difference between ITP children and healthy children. It is hoped that the methods proposed in this paper can non-invasively and objectively describe the characteristics of ITP infrared thermal imaging of children, and provide a new ideas for ITP diagnosis. 10.7507/1001-5515.201912053
    Medical Infrared Thermography in back pain osteopathic management. Polidori Guillaume,Kinne Marion,Mereu Tracy,Beaumont Fabien,Kinne Mélanie Complementary therapies in medicine OBJECTIVES:The objective of this study was to provide proof-of-concept for the use of Medical Infrared Thermography to verify both diagnosis and osteopathic management accuracy in back pain. METHODS:A 50-year-old woman with acute back pain syndrome volunteered to participate in this study. RESULTS:Prior the treatment, thermal image reveals that in a sagittal plane, the inflammation extends from vertebra D8 to L3 with a maximum inflammation between vertebrae D10 to L1. Post-treatment, Medical Infrared Thermography only shows a slight inflammation along the lumbar furrow that does not induce pain in the patient. CONCLUSION:Medical Infrared Thermography has made it possible to scientifically support the osteopathic approach to back pain, both in the initial diagnostic phase and in the validation phase of treatment effectivess. 10.1016/j.ctim.2018.05.010
    Dynamic InfraRed Thermography (DIRT) in DIEP-flap breast reconstruction: A review of the literature. Thiessen Filip E F,Tondu Thierry,Cloostermans Ben,Dirkx Yarince A L,Auman Dorien,Cox Stefaan,Verhoeven Veronique,Hubens Guy,Steenackers Gunther,Tjalma Wiebren A A European journal of obstetrics, gynecology, and reproductive biology In the industrialised world still 34% of the breast cancer patients are surgically treated by a mastectomy. Breast cancer patients in general have a good prognosis and a long-term survival. Therefore, it is important that the treatment doesn't focus only on survival but also on the quality of life. Breast reconstruction improves the quality of life. A breast reconstruction with an autologous free DIEP (Deep Inferior Epigastric artery Perforator) flap is one of the preferred options after mastectomy. A challenging step in this procedure is the selection of a suitable perforator that provides sufficient blood supply for the flap. Current techniques to locate the perforator vessels include handheld Doppler, colour Doppler ultrasound (CDU), Magnetic resonance angiography (MRA), computer tomographic angiography (CTA) and dynamic infrared thermography (DIRT). At present CTA is the golden standard and DIRT a new option. The objective of this article is to document whether DIRT can accurately map the position of the perforators and measure their influence on the perfusion of the flap in order to select the best perforators to improve the outcome of breast reconstructions with free DIEP flaps. A systematic review of the literature published between January 1998 and November 23th 2018 was conducted regarding the possible benefit of dynamic infrared thermography (DIRT) in DIEP-flap breast reconstructions. The databases PubMed and Web of Science were used to search for qualified articles. Inclusion criteria were women who underwent a breast reconstruction by means of a DIEP flap where DIRT was used to analyse the blood supply of the flap. The search yielded a total of fourteen suitable articles: six articles being descriptive clinical studies, three case reports, three expert opinions/Overview articles and two systematic reviews. There are only a limited number of studies looking at the use of DIRT in breast reconstruction with DIEP-flaps. Adequate identification of the dominate vessel(s) in DIEP reconstruction is essential for a successful outcome. DIRT appears to be an ideal alternative technique for the identification of the dominant perforators of the flap. With the use of DIRT it is possible to identify the dominant vessel(s) preoperatively. The use of DIRT during the operation allows the tailoring of the surgery and postoperative use may identify vascularisation problems in an early stage. Additional high-quality studies are needed, but DIRT seems to be a valuable investigation for the pre-, per- and postoperative phase of DIEP-flap reconstructions. 10.1016/j.ejogrb.2019.08.008
    Infrared thermography in the evaluation of meibomian gland dysfunction. Su Tai-Yuan,Ho Wei-Ting,Chiang Shu-Chiung,Lu Chien-Yi,Chiang Huihua Kenny,Chang Shu-Wen Journal of the Formosan Medical Association = Taiwan yi zhi BACKGROUND/PURPOSE:To evaluate meibomian gland dysfunction (MGD) by infrared thermography. METHODS:An observational study was conducted at the Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Participants included 89 MGD patients (30 in Grade 1, 49 in Grade 2, and 10 in Grade 3) and 65 controls. The close-eye thermographic images of the eyelid were obtained noninvasively by infrared thermography. Temperatures at 8 regions of interest (ROIs) of the eyelid margin and a reference temperature at the center of the upper eyelid were measured. The temperature ratio was defined as the temperature of ROI divided by the reference temperature. RESULTS:Eyelid margin temperature measured by infrared thermography increased from temporal side (ROI 1) to the nasal side (ROI 8) of the eye in both MGD patients and control groups. The temperature ratios were significantly higher in MGD participants than in controls, especially at ROI 8. CONCLUSION:The eyelid margin temperature measured by infrared thermography was higher in MGD participants. Further development of this infrared thermography system may become a rapid and non-invasive tool for MGD screening. 10.1016/j.jfma.2016.09.012
    Frontal infrared thermography in healthy individuals and chronic migraine patients: Reliability of the method. Antonaci Fabio,Rossi Elena,Voiticovschi-Iosob Cristina,Dalla Volta Giorgio,Marceglia Sara Cephalalgia : an international journal of headache BACKGROUND:The use of frontal infrared thermography in the diagnosis of primary headaches provided scattering results due to measurement fluctuations and different types of headaches or research protocols. OBJECTIVE:This study aims to assess the reliability of frontal infrared thermography in healthy individuals and provide a preliminary evaluation in chronic migraine patients using a commercial infrared thermal camera. METHODS:Thermographic images were acquired in 20 controls and 15 patients at three consecutive time-points in two daily sessions. The Side Difference and Asymmetry Index parameters were defined. The reproducibility of the measurements, the correlation of Asymmetry Index and Side Difference with clinical evaluations and patient perceptions, and the ability of the parameters to discriminate between patients and controls were investigated. RESULTS:We reported a good reproducibility of the measurements (Inter-class Correlation Coefficient > 0.75 and Coefficient of Variation < 13.4%), independent from external factors. The Side Difference was significantly different between patients and controls (  p < 0.001). The Asymmetry Index showed good correlation with the side of unilateral pain (  p = 0.0056). CONCLUSIONS:Frontal infrared thermography can be used to quantify the difference between the right and the left side of frontal vascular changes in chronic migraine patients, provided that standardized conditions are satisfied. 10.1177/0333102418788341
    Use of infrared thermography in a case of systemic envenomation by the coral snake Micrurus frontalis (Duméril et al., 1854) in Sao Paulo, Brazil. Medeiros Carlos Roberto de,Souza Solange Nogueira de,Lara Amanda Nazareth,Grego Kathleen Fernandes Toxicon : official journal of the International Society on Toxinology Infrared thermography is a technique that quantifies the thermal (infrared) radiation emitted by an object and produces a high-resolution, digital thermal image of it. Medically, this technique is used to visualize the body's surface temperature distribution in a non-invasive, safe, and convenient fashion. However, to the best of our knowledge, the use of infrared thermography for assessing the systemic effects of envenomation by coral snakes has not been reported. In this case report, we describe the use of this technique in the management of a case of snakebite in Sao Paulo, Brazil. A 51-year-old woman was bitten on the back of the right hand by Micrurus frontalis, a species of coral snake, 10 min prior to her arrival at the hospital. Infrared imaging performed at admission revealed elevated temperatures at the bite site and in the elbow, as well as the preservation of a normal distal thermal gradient in both hands. A few minutes later, the patient developed muscle weakness in the upper limbs and in the eyelids, and infrared imaging showed an alteration of the thermal gradient in both hands, reflecting the systemic action of the venom. Following these observations, the patient was treated with the specific antivenom and was discharged 48 h post admission. At the two-week follow-up, the thermal image obtained showed no anomalies, indicating the recovery of the patient. Hence, infrared thermography can be very useful in the early identification of systemic neurotoxicity in cases of Micrurus snake bites, facilitating the decision to prescribe the antivenom. 10.1016/j.toxicon.2019.03.016