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Infrared ImagingA casebook in clinical medicine

Infrared ImagingA casebook in clinical medicine

Francis RingUniversity of South Wales, UK

Anna JungMilitary Institute of Medicine, Poland

Janusz ZuberMilitary Institute of Medicine, Poland

IOP Publishing, Bristol, UK

ª IOP Publishing Ltd 2015

All rights reserved. No part of this publication may be reproduced, stored in a retrieval systemor transmitted in any form or by any means, electronic, mechanical, photocopying, recordingor otherwise, without the prior permission of the publisher, or as expressly permitted by law orunder terms agreed with the appropriate rights organization. Multiple copying is permitted inaccordance with the terms of licences issued by the Copyright Licensing Agency, the CopyrightClearance Centre and other reproduction rights organisations.

Permission to make use of IOP Publishing content other than as set out above may be soughtat [email protected].

The authors have asserted their right to be identified as the authors of this work in accordance withsections 77 and 78 of the Copyright, Designs and Patents Act 1988.

ISBN 978-0-7503-1143-4 (ebook)ISBN 978-0-7503-1144-1 (print)ISBN 978-0-7503-1145-8 (mobi)

DOI 10.1088/978-0-7503-1143-4

Version: 20150801

IOP Expanding PhysicsISSN 2053-2563 (online)ISSN 2054-7315 (print)

British Library Cataloguing-in-Publication Data: A catalogue record for this book is availablefrom the British Library.

Published by IOP Publishing, wholly owned by The Institute of Physics, London

IOP Publishing, Temple Circus, Temple Way, Bristol, BS1 6HG, UK

US Office: IOP Publishing, Inc., 190 North Independence Mall West, Suite 601, Philadelphia,PA 19106, USA

Dedicated to the late Baron Professor Leopold Thibault de Boesinghe MD ofGent University Belgium, a pioneer in medical thermography and former President

of the European Association of Thermology.

Contents

Preface xiii

Acknowledgements xiv

About the editors xv

List of contributors xvi

Part 1 Technical

1 The technique of infrared imaging in medicine 1-1

1.1 Introduction 1-1

1.2 Location for thermal imaging 1-2

1.2.1 Investigation room 1-2

1.2.2 Ambient temperature control 1-2

1.2.3 Room temperature indication 1-2

1.2.4 Computer and other equipment 1-2

1.2.5 Patient cubicle 1-3

1.3 The imaging system 1-3

1.3.1 The camera system 1-3

1.3.2 Temperature reference 1-3

1.3.3 Mounting the imager 1-3

1.3.4 Camera initialization 1-4

1.3.5 Image processing 1-4

1.4 The patient 1-4

1.4.1 Patient information 1-4

1.4.2 Pre-imaging equilibration 1-5

1.4.3 Positions for imaging 1-5

1.4.4 Field of view 1-5

1.5 Report generation 1-6

1.5.1 Colour and temperature scale 1-6

1.5.2 Processing the reported image 1-6

1.5.3 Archiving images and data 1-6

1.6 Conclusion 1-7

References 1-7

vii

2 The reproducibility of standard positions used for imagecapturing within the standard protocol for thermal imaging

2-1

3 The reliability of temperature readings from selected standardviews for thermal imaging

3-1

4 The influence of colour scale on the accuracy of infraredthermal images

4-1

References 4-11

Part 2 The head and neck

5 New standards for fever screening with thermal imaging systems 5-1


5.1.1 Camera specification 5-3

5.1.2 Is the standard being applied? 5-3

5.1.3 A clinical study for fever detection in children 5-4

5.2 Method 5-4

5.3 Results 5-4

5.3.1 Temperature data 5-5

5.4 Discussion 5-6

5.5 Conclusion 5-10

Acknowledgments 5-10

References 5-10

6 Infantile haemangiomas—IR thermography in assessment 6-1

7 Exploratory thermal and laser speckle contrast imagingmeasurements of eye inflammation in a case of thyroideye disease

7-1

7.1 Description 7-1

7.2 Clinical presentation 7-1

7.3 Investigations and procedures, diagnostic findings 7-2

7.4 Brief discussion and conclusion 7-3

References 7-3

Infrared Imaging

viii

8 Thermographic examination of a boy with an abscessnear to the maxillary sinus

8-1

9 Malignant melanoma characterization with thermaland visual imaging

9-1

10 Thermographic monitoring of ophthalmic surgery—extractionof a cataract

10-1

10.1 Conclusions 10-7

11 Application of thermal imaging in the diagnosis ofinflammatory changes of nasal sinusitis

11-1

References 11-4

12 Thermal evaluation of the temperature distribution in theoral cavity during dental operations

12-1

Part 3 The trunk

13 Thermographic assessment of the presence of fatty tumoursin myoclonic epilepsy with ragged red fibres

13-1

13.1 Description 13-1




References 13-2

14 Tietze’s syndrome and the role of infrared imaging in thedifferential diagnosis of acute chest pain in adolescents

14-1

15 Thoracic vertebral block—the technique of injecting localanaesthetic

15-1

References 15-6

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ix

Part 4 The upper extremities

16 The sensitivity of infrared imaging for diagnosing Raynaud’sphenomenon is dependent on the method of temperatureextraction from thermal images

16-1


16.2 Methods 16-1

16.3 Statistical evaluation 16-3

16.4 Results 16-4

16.5 Discussion 16-5

16.6 Conclusion 16-5

References 16-6

17 Nerve entrapment and skin temperature of the human hand 17-1

17.1 Carpal tunnel syndrome and thoracic outlet syndrome 17-1

17.2 Evaluation of thoracic outlet syndrome 17-2

18 Imaging assessments of patients with suspected systemicsclerosis and associated inflammatory lung disease

18-1





References 18-3

19 The use of infrared thermography to differentiate‘cold intolerance’ from ‘true Raynaud’s phenomenon’in the context of fibromyalgia

19-1

19.1 Case history 19-1

19.2 Discussion 19-3

References 19-3

20 Hand arm vibration syndrome documented by thermalimaging—a case report

20-1


20.2 Case history 20-1

Infrared Imaging

x

21 Thermal imaging and its potential for arterio-venous fistulafunction assessment

21-1





References 21-4

22 Thermographic monitoring of blood flow in arterio-venousfistulas

22-1

Part 5 The lower extremities

23 A case study in the diagnosis of a grade III ankle sprainusing a combination of medical images

23-1

24 Thermal imaging in the monitoring of grade III ankle sprainrehabilitation—a case study

24-1

25 Application of thermal imaging in the diagnosis and treatmentmonitoring of complex regional pain syndrome type I

25-1

26 The thermal imaging potential for assessing diabeticCharcot foot syndrome

26-1





References 26-3

27 Thermal imaging of the foot in different forms ofdiabetic disease

27-1

28 Thermal imaging in the screening diagnosis of cruralvarices in adolescents

28-1

Infrared Imaging

xi

29 Thermographic investigation in the diagnosis of femoralvein thrombosis

29-1

30 Infrared thermal imaging of critical leg ischaemia 30-1

31 Infrared imaging of angiomatosis syndrome(Klippel–Trénaunay syndrome)

31-1

32 Thermal imaging: a monitoring tool for the treatment oferythromelalgia

32-1

Infrared Imaging

xii

Preface

Twelve years ago, Anna Jung, Janusz Zuber and Francis Ring edited the Casebookof Infrared Imaging in Clinical Medicine with text in Polish and English forMedPress in Poland.

Great progress has since been made in both infrared camera techniques and theunderstanding of the significance of infrared imaging in clinical medicine. Whilst thisnew book contains about a third of the chapters from the original casebook, it nowprovides significantly more than a simple update of the field. In addition to includingmany new case reports signaling the importance and extension of clinical medicalinfrared imaging, the theoretical section has been extended with significant papers,some previously published in journals, that provide a framework for recording,evaluating and interpreting infrared thermal images in clinical medicine.

The order of chapters follows the anatomical regions and is not a catalogue ofdiseases. In this way it makes clear that variations in the level and distribution oftemperature are not a ‘signature of disease’, but a strong indicator of disease orphysiologic activity. As heat radiation is mostly determined by blood flow in thesuperficial skin vasculature, and blood flow itself is dependent on the portion ofcardiac output, the density of blood vessels and the width of the vascular bed, widerand more vessels will result in higher blood flow leading to more heat radiationwhich is coded as higher temperature in infrared thermal images. Such an increase oftemperature might be the result of inflammation, newly built vessels or simply ofvasodilation due to an effector response of the thermoregulation system.

Under well controlled environmental conditions and patient preparation, thermo-regulation responses can be avoided, and in patients with an established diagnosisthe course of temperature recorded in a lesion with infrared imaging reflects theactivity of the underlying disease. Areas of low skin temperature indicate reducedblood flow and the course of temperature after applying a cold stimulus candifferentiate short lasting episodes of vasoconstriction from severe vasospasms orpoor perfusion due to occluded vessels.

This new casebook provides good examples of the value of infrared imaging as anoutcome measure in clinical medicine.

Professor Kurt Ammer MD, PhD

xiii

Acknowledgements

The editors wish to thank all the contributing authors to this book—the clinicalcolleagues and members of the European Association of Thermology who haveprovided images and case reports. This has resulted in a widespread record ofclinical experience with this technology of infrared thermal imaging. Not allsubmitted material could be included, so we thank all those colleagues who suppliedmaterial for this particular project. There are also some published papers that havebeen in particular demand since their original publication. We therefore expressthanks to the journals that have given permission for these selected papers to bereproduced. To Medpress in Warsaw we express our thanks for the cases selected forinclusion from the earlier shorter Casebook published over a decade ago. Someearlier papers included indicate that the quality of the thermographic images hasdramatically improved over recent years, due to significant improvements in thetechnology. We thank those manufacturers who have assisted in the clinical studies,especially where excellent high resolution images have been obtained.

xiv

About the editors

Francis Ring

Francis Ring has worked for over 50 years with infrared thermog-raphy in medicine. He is currently Director of The Medical ImagingResearch Unit at The University of South Wales in the UnitedKingdom. He holds a medal awarded by The Combined Colleges(Medicine, Surgery and Gynaecology in the UK) for his lifetimeresearch into medical applications of infrared imaging.

Anna Jung

Anna Jung, is Professor of Pediatrics with a DSc in Medical Sciencesat the Central Clinical Hospital of Military Institute of Medicine inWarsaw, Poland. Professor Jung has worked for over 20 years withinfrared thermography in medicine and conducts studies, supportedby the State Committee for Scientific Research, on the application ofthermographic methods in medical diagnostics.

She was awarded the Knight’s Cross of the Order of PoloniaRestituta by the President of Poland for her achievements in thefields of medical science.

Janusz Żuber

Janusz Żuber, MD PhD has experience of over 20 years in the ClinicalThermography of the Central Clinical Hospital of Military Instituteof Medicine in Warsaw, Poland. He is the author of numerous workson the application of liquid crystal thermography and thermalimaging in allergic medicine and other applications in medicaldiagnostics.

xv

List of contributors

John AllenMicrovascular DiagnosticsRegional Medical Physics DepartmentThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUKandInstitute of Cellular MedicineNewcastle UniversityNewcastle upon TyneUK

Kurt AmmerEuropean Association of ThermographyViennaAustriaandMedical Imaging Research UnitFaculty of Mathematics, Computing and ScienceUniversity of South WalesPontypriddWalesUK

K BilskaDepartment of Oncological Surgery of Children and AdolescentsMother and Child InstituteWarsawPoland

Stephen BurnettMicrovascular DiagnosticsRegional Medical Physics DepartmentThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK

Rui CarvalhoDiabetic Foot ClinicCentro Hospitalar do Porto EPEPortoPortugal

xvi

Mirosław DąbrowskiInstitute of OptoelectronicsMilitary University of TechnologyWarsawPoland

Costanzo Di MariaMicrovascular DiagnosticsRegional Medical Physics DepartmentThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUKandInstitute of Cellular MedicineNewcastle UniversityNewcastle upon TyneUK

Jane DickinsonDepartment of OphthalmologyThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK

Ana DominguesFaculty of EngineeringUniversity of PortoPortoPortugal

Rafał DulskiInstitute of OptoelectronicsMilitary University of TechnologyWarsawPoland

Liliana EstevesFaculty of EngineeringUniversity of PortoPortoPortugal

V FlowerThe Royal National Hospital for Rheumatic DiseasesBathUK

Infrared Imaging

xvii

Ian ForrestMusculoskeletal UnitThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK

Joaquim GabrielLABIOMEP, INEGIFaculty of EngineeringUniversity of PortoPortoPortugal

Z GacionClinic of Internal Diseases, Hypertension and AngiologyMedical University of WarsawWarsawPoland

Ł Gadomska vel BetkaClinic of Internal Diseases, Hypertension and AngiologyMedical University of WarsawWarsawPoland

Lech GawronOphthalmology ClinicDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Grainne GormanDepartment of NeurologyRoyal Victoria InfirmaryThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUKandWellcome Trust Centre for Mitochondrial ResearchInstitute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK

Infrared Imaging

xviii

Ryszard GrendaNephrology Clinic InstitutePomnik – Centrum Zdrowia DzieckaWarsawPoland

Bridget GriffithsInstitute of Cellular MedicineMedical SchoolNewcastle UniversityNewcastle upon TyneUK

D HartDepartment of Clinical MeasurementThe Royal National Hospital for Rheumatic DiseasesBathUK

Katarzyna JobsDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Anna JungDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Bolesław KalickiDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Marek KlewarRadiology DepartmentMilitary School of MedicineWarsawPoland

Infrared Imaging

xix

Jakub KlimkiewiczDepartment of Anesthesiology and Intensive CareMilitary Institute of MedicineWarsawPoland

A KoszyckaThermal Laboratory of Pediatric, Nephrology and Allergology ClinicMilitary Institute of MedicineWarsawPoland

A KrawczykICT DepartmentMilitary Institute of MedicineWarsawPoland

Rafał KuligowskiDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Nicola LeechNewcastle Diabetes CentreCentre for Ageing and VitalityThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle uopn TyneUK

Aleksander LigęzińskiENT Department ClinicCentral HospitalMilitary School of MedicineWarsawPoland

A Lipińska-OpałkaDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Infrared Imaging

xx

Weronika MachuraDepartment of Anesthesiology and Intensive CareMilitary Institute of MedicineWarsawPoland

Ana MarquesFaculty of EngineeringUniversity of PortoPortoPortugal

Marcin MożańskiDepartment of Anesthesiology and Intensive CareMilitary Institute of MedicineWarsawPoland

J MrózRehabilitation ClinicMilitary Institute of MedicineWarsawPoland

Piotr MurawskiICT DepartmentMilitary Institute of MedicineWarsawPoland

B Nurowska-WrzosekClinic of Internal Diseases, Hypertension and AngiologyMedical University of WarsawWarsawPoland

Crispian OatesVascular UltrasoundDepartment of RadiologyThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK

Infrared Imaging

xxi

João OliveiraFaculty of MedicineUniversity of PortoPortoPortugal

Michał OsieckiRadiology DepartmentCentral HospitalMilitary School of MedicineWarsawPoland

J D PaulingThe Royal National Hospital for Rheumatic DiseasesBathUK

Wojciech PerdzyńskiDepartment of Children SurgeryCentral HospitalMilitary School of MedicineWarsawPoland

Petros PerrosInstitute of Genetic MedicineNewcastle UniversityNewcastle upon TyneUK

Madalena PimentaDepartment of RadiologyHospital de São JoãoPortoPortugal

Cezary PogorzelskiDentistry InstituteCentral Clinical HospitalMilitary Medical AcademyWarsawPoland

Infrared Imaging

xxii

Marco RebeloPlastic and Reconstructive Surgery ServiceIPO-PortoPortoPortugal

E F J RingMedical Imaging Research UnitFaculty of Mathematics, Computing and ScienceUniversity of South WalesPontypriddWalesUK

Derek RobertshawNewcastle Diabetes CentreCentre for Ageing and VitalityThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle uopn TyneUK

Radosław RóżyckiOphthalmology ClinicDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

A RusteckaDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Bartosz RusteckiDepartment of Anesthesiology and Intensive CareMilitary Institute of MedicineWarsawPoland

J ShipleyDepartment of Clinical MeasurementThe Royal National Hospital for Rheumatic DiseasesBathUK

Infrared Imaging

xxiii

Marek StańczykII Surgery DepartmentCentral HospitalMilitary School of MedicineWarsawPoland

W StankiewiczMilitary Institute of Hygiene and EpidemiologyWarsawPoland

Andrzej StankiewiczOphthalmology ClinicDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

David TalbotRenal Medicine and Transplant CentreThe Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK

João TorresFaculty of MedicineUniversity of PortoPortoPortugalandDepartment of OrthopaedicsHospital de São JoãoPortoPortugal

Paweł TwarkowskiRadiology DepartmentCentral HospitalMilitary School of MedicineWarsawPoland

Infrared Imaging

xxiv

Ricardo VardascaLABIOMEP, INEGIFaculty of EngineeringUniversity of PortoPortoPortugalandMedical Imaging Research UnitFaculty of Mathematics, Computing and ScienceUniversity of South WalesPontypriddWales

W WoźniakDepartment of Oncological Surgery of Children and AdolescentsMother and Child InstituteWarsawPoland

Paweł ZaborowskiDentistry InstituteCentral Clinical HospitalMilitary Medical AcademyWarsawPoland

Stanisław ŻmudaDentistry InstituteMilitary Medical AcademyWarsawPoland

Janusz ŻuberDepartment of Pediatrics, Pediatric Nephrology and AllergologyMilitary Institute of MedicineWarsawPoland

Infrared Imaging

xxv

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This content has been downloaded from IOPscience. Please ... · Under well controlled environmental conditions and patient preparation, thermo-regulation responses can be avoided,