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The non-invasive infrared technique was used in case of the thermal imaging of patients suffering from spine diseases. Measurements were performed for the group of 50 patients during whole body cryotherapy at the second, fifth and tenth day of the rehabilitation cycle. An enhancement of the profile of skin temperature due to body cooling caused an increase in the diagnostic sensitivity of thermovision. The temperature parameters such as temperature contrast (ΔT=T max−T min) and relative change of contrast ratio defined as (ΔT)/(T mean) in the region of interest (ROI’s) were used to point out differences between the healthy patients and patients suffering from ankylosing spondylitis, sciatica and spondyloarthrosis. The value of the thermovision diagnostic in the case of spine diseases was confirmed by statistical analysis. KeywordsThermal imaging-Temperature-Cryotherapy
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Thermovision diagnostics in chosen spine diseases treated
by whole body cryotherapy
Armand Cholewka
Zofia Drzazga
Aleksander Sieron
´
Agata Stanek
Received: 24 January 2010 / Accepted: 5 May 2010 / Published online: 21 May 2010
Ó Akade
´
miai Kiado
´
, Budapest, Hungary 2010
Abstract The non-invasive infrared technique was used
in case of the thermal imaging of patients suffering from
spine diseases. Measurements were performed for the
group of 50 patients during whole body cryotherapy at the
second, fifth and tenth day of the rehabilitation cycle. An
enhancement of the profile of skin temperature due to body
cooling caused an increase in the diagnostic sensitivity of
thermovision. The temperature parameters such as tem-
perature contrast (DT = T
max
- T
min
) and relative change
of contrast ratio defined as (DT)/(T
mean
) in the region of
interest (ROI’s) were used to point out differences between
the healthy patients and patients suffering from ankylosing
spondylitis, sciatica and spondyloarthrosis. The value of
the thermovision diagnostic in the case of spine diseases
was confirmed by statistical analysis.
Keywords Thermal imaging Temperature
Cryotherapy
Introduction
Whole body cryotherapy is a medical modality that is usu-
ally correlated with typical rehabilitation procedures
[1, 2]. In this kind of treatment patient is influenced by very
low temperature (lower than -100 °C) applied to the whole
body surface for a period of 2–3 min in the cryogenic
chamber in order to cause physiological and biochemical
reactions in the organism. This therapy facilitates doing
exercises and finally leads to the shortening of the process of
healing [1, 2]. There have been a lot of papers about cold
treatment [1, 2] which include whole body cryotherapy but
only few of them touched the problem of thermal imaging
due to cold impact on human body [35]. Nowadays the
whole body cryotherapy is being used widely in many
applications, especially in motion organ diseases such as
degeneration and inflammatory states of joints (monoar-
thritis and oligoarthritis) and periarthritis, rheumatism, low
back pain diseases, inflammatory, degeneration states of
spinal vertebrae joints and fibromialgia [2, 613]. It was also
reported that cryotherapy has a positive influence on mental
health which can be explained by an increase of concentration
of some hormones. What is more, it helps to destroy the free
radicals and is being used in osteoporosis preventive treat-
ment [7]. Moreover the cryotherapy has applications in sle-
rosis multiplex and other nervous system diseases. Diseases
like sciatica, discopathy and many other spine lesions are
connected with perturbations of nervous system [1417].
Commonly occurring spine diseases are ankylosing
spondylitis (AS), sciatica and spondyloarthrosis (SP). AS
previously known as Bechterew’s disease is a form of
spondyloarthritis and has genetic predisposition. It is a
chronic, painful, inflammatory arthritis, primarily affecting
spine and sacroiliac joints. It can even cause a fusion of the
spine and the inflammatory state occurs in almost all joints
of the spine. It is also called the bamboo spine [18, 19]. AS
is mainly male disease. Sciatica is a set of symptoms
including pain that may be caused by compression and
irritation of one of five nerve roots that give rise to the
sciatic nerve or by compression or irritation of the sciatic
A. Cholewka (&) Z. Drzazga
A. Chełkowski Institute of Physics, Department of Medical
Physics, University of Silesia, Uniwersytecka 4, 40-007
Katowice, Poland
e-mail: armand.cholewka@gmail.com
A. Sieron
´
A. Stanek
Department and Clinic of Internal Diseases, Angiology and
Physical Medicine, Medical University of Silesia, Batorego 15,
41-902 Bytom, Poland
123
J Therm Anal Calorim (2010) 102:113–119
DOI 10.1007/s10973-010-0873-y
nerve itself. The pain is usually felt in the lower lumbar
region, one leg or even in the foot. Sciatica is generally
caused by the compression of lumbar nerves L4 or L5 or
sacral nerves S1, S2 or S3 and far less commonly by
compression of the sciatic nerve itself. Inflammatory states
of soft tissue in the vicinity of loins are also commonly
occurring symptoms. The SP is also a spine disease which
occurs mainly in the lumbar region of spine and in the
cervical. This progressive destruction of the facet joints and
is characterized by loss of articular cartilage and production
of osteophytes. This disease can lead to a narrowing of the
neural foramina in the lumbar regions and stenosis of spinal
canal causing inflammatory state and back pain [18, 19].
One type of therapy which is used to treat AS, SP as well
as sciatica is whole body cryotherapy. Therefore, this work
presents systematic studies of patients with spine diseases
due to body cooling by means of thermal imaging.
Materials and methods
The total study population consisted of 18 patients suffer-
ing from AS (18 male aged 50.6 ± 8.0), 15 patients
suffering from sciatica (13 male, two female aged
44.7 ± 7.6), six patients suffering from SP (six male
aged 46.0 ± 11.7) and 11 healthy people (11 male aged
34.0 ± 7.9). The line marked along the spine in the range
of vertebrates from Th1/Th2 to L5/S1 was taken into
consideration for whole study population.
The investigations were carried out at the Provincial
Centre of Rheumatologist in Goczałkowice Zdro
´
j (WORR),
where the cryogenic chamber was installed. In order to get
very low temperatures (-120 °C) in the cryogenic chamber,
liquid air was used. All patients were influenced by very low
temperature in the cryogenic chamber for 3 min.
All patients were examined by a physician. They were
requested not to smoke, drink alcohol or hot drinks for 4 h
before the experiment.
The distribution of the skin surface temperature was
monitored by means of a Thermovision Camera A40M
calibrated by a black body. The camera sensitivity was
0.07 K. High-resolution images (320 9 240 pixels) can be
obtained with more than 76,800 individual measurement
points per image at a refresh rate of 50/60 Hz.
The thermograms of chosen regions of interests (ROI)
were performed before and immediately after the whole
body cryotherapy, at the second (beginning), fifth (middle)
and tenth (last) day of treatment in a special room outside
the cryogenic chamber where the temperature was stabi-
lized (22 ± 1 °C). The distance between the camera and
the body was about 1.2–1.5 m (depending on height and
size of the patient). It was necessary to follow the standard
protocol of infrared imaging in medicine [20, 21].
Statistical analysis were done with Statistica 7.1. Dif-
ferences with a p \ 0.05 were regarded as significant.
Results and discussion
Representative thermograms of the back of a healthy man
(H) and a patient suffering from AS performed before (B)
and after (A) whole body cryotherapy session at the same
period of rehabilitation cycle (fifth day of cryotherapy
treatment) in the same temperature scale are shown in Fig. 1.
One can see from Fig. 1 that a significant decrease of skin
temperature is observed after a cold impact. Thermal map-
ping obtained after cryotherapy is clearer and reveals marked
temperature differentiation that increases a potential diag-
nostic value of thermal imaging which was mentioned in
previous papers [35]. It follows from comparison of
21.0 °C
35.0 °C
22
24
26
28
30
32
34
LI01
21.0 °C
35.0 °C
22
24
26
28
30
32
34
LI01
H
B
H
A
21.0 °C
35,0 °C
22
24
26
28
30
32
34
LI01
21.0 °C
35.0 °C
22
24
26
28
30
32
34
LI01
AS
B
AS
A
Fig. 1 Thermograms of
patients’ backs with marked
lines along the spine of a
healthy man (H) and a patient
suffering from ankylosing
spondylitis (AS) performed
before and after whole body
cryotherapy at the same period
of the rehabilitation cycle
114 A. Cholewka et al.
123
temperature variation along the spine that there are no tem-
perature anomalies along the spinal column for the healthy
(both before and after cold impact) unlike patients with spine
diseases. The areas with increased temperature connected
with inflammatory states and with an abnormal decrease of
temperature suggesting degeneration states may occur in
different spine regions [35, 22]. The character of tempera-
ture variations depends on the degree of advance and also on
the kind of illness. It is interesting to compare that the ther-
mograms of the back of a patient suffering from AS (Fig. 1)
with representative thermograms of patients with sciatica (S)
and SP performed after cold impact, which are shown in
Fig. 2.
For a patient with sciatica, temperature anomalies are
observed mainly in the lower lumbar region. The increase
in skin temperature occurs not only along the spine, but
also in the areas over the tissues adjacent to the spine on its
both sides in the lower lumbar region [4]. Similar situations
are observed in the thermograms of patients suffering from
SP where the inflammatory state is also connected with the
lower lumbar region but the range of disease affecting the
spine is usually wider than in sciatica (Fig. 2, SP) while
tissues adjacent to the spine are less affected.
As far as AS patients are concerned, the areas of higher
temperature are observed almost along the whole spinal
column (Fig. 1,AS
A
) which are a specificity of this disease
that is in fact an advanced form of spondyloarthritis. This is
a chronic inflammatory arthritis in which the inflammatory
state is connected with joints along the whole spine [18,
19]. Therefore, we observed the area characterized by
higher temperature almost along the whole spine.
For better insight into the problem the temperature plots
along and perpendicular to the spine for studied groups of
patients were performed.
Figure 3 shows the plots of the temperature along a
vertical line characterizing spinal columns in the range from
Th1/Th2 to L5/S1 for patients diagnosed with sciatica (S),
SP and AS, respectively, performed before (b) and after (a)
whole body cryotherapy. It is clear that plots show marked
changes of skin temperature after cold impact in compari-
son with plots performed in normal conditions, which
confirm an increase of thermal imaging diagnostic value.
The anomalies of temperature (increase and decrease) can
be treated as connected with different pathology states. One
can see that for patient with sciatica (S) increase of tem-
perature is observed only in the lower lumbar region. The
temperature plot performed for patient SP point out the
marked inflammatory states in the range from L2/L3 to L5/
S1, the degeneration state in the vicinity of Th11/Th12 and
the weak inflammatory state from Th6/Th7 to Th9/Th10
vertebrates. In the case of patient with AS the skin increased
temperature on the level Th5/Th6—Th8/Th9 and Th11/
25.0 °C
35.0 °C
26
28
30
32
34
25.0 °C
35.0 °C
26
28
30
32
34
S
A
SP
A
Fig. 2 Thermograms of the
backs of patients suffering from
sciatica (S) and
spondyloarthrosis (SP)
performed after whole body
cryotherapy at the same period
of rehabilitation cycle
°C
20
22
24
26
28
30
32
34
(SP)
b
a
°C
22
24
26
28
30
32
34
b
(S)
a
Th1/Th2
Vertebras
L5/S1
°C
22
24
26
28
30
32
34
(AS)
b
a
Fig. 3 The plots of temperature characterizing the spinal column in
the range of vertebras from Th1/Th2 to L5/S1 for patient with sciatica
(S), spondyloarthrosis (SP) and ankylosing spondylitis (AS), respec-
tively, performed before (b) and after (a) cryotherapy at fifth day of
rehabilitation cycle
Thermovision diagnostics in chosen spine diseases 115
123
Th12—L2/L3 indicates inflammatory states occurring
almost along all spine. The temperature plots seems to be
useful in differentiating between healthy and some spine
diseases if the temperature anomalies connected with
pathological states are larger than measuring error (the
precision was ±2% of the temperature range).
It is noteworthy to test temperature plots along the lines
performed perpendicular to the spinal column especially for
the patient diagnosed with sciatica in Fig. 4. Marked
increase of temperature on both sides of the spine confirm
the inflammatory states of tissues adjacent to the spine,
which is characteristic for this kind of disease. The tem-
perature anomalies observed along the line perpendicular to
the spine were also analysed in detail in our previous work
[4]. It was found that increased temperature in adjacent
tissues to the spine can occur not only in the case of sciatica,
20
22
24
26
28
30
32
34
b
a
o
C
Lower back width
The spinal cord line
Fig. 4 The plots of temperature along the line perpendicular to the
spinal column for patient with sciatica (S), performed before (b) and
after (a) cryotherapy
Table 1 The temperature parameters used in Kruskal–Wallis’ test
Temp./
°C
Gender T
mean
before
cryotherapy
T
mean
after
cryotherapy
T
max
before
cryotherapy
T
max
after
cryotherapy
T
min
before
cryotherapy
T
min
after
cryotherapy
DT = T
max
-
T
min
after
Q = DT/
T
mean
after
Healthy (H)
1 Male 33.6 21.9 34.3 23.2 32.8 20.4 2.8 0.13
2 Male 32.3 24.7 33.3 25.7 29.9 22.6 3.1 0.13
3 Male 32.3 26.7 32.9 28.4 31.6 24.6 3.8 0.14
4 Male 33.4 27.9 34.6 29.8 32.9 26.8 3 0.11
5 Male 33.2 27.6 34.1 28.5 32.4 25.6 2.9 0.11
6 Male 29.7 27.2 30.7 28.3 27.5 26.1 2.1 0.08
7 Male 32.9 27.7 33.9 28.6 32.2 27 1.7 0.06
8 Male 33.1 22.9 34.1 26.3 32 20.9 4 0.17
9 Male 33.3 25.5 34.2 26.6 31.4 22.7 3.8 0.15
10 Male 32.5 25.1 33.4 26 31.9 22.3 2.7 0.11
11 Male 32.3 27.5 32.6 28.4 31.5 25.3 3.1 0.11
Mean 32.60 25.88 33.46 27.25 31.46 24.03 3.00 0.12
SD 1.1 2.1 1.1 1.9 1.5 2.3 0.7 0.03
Patients with spondyloarthrosis (SP)
1 Male 32.8 22.3 33.4 25.2 31.8 19.3 5.9 0.26
2 Male 30.6 24.9 31.5 27.3 30 20.7 6.6 0.27
3 Male 32.9 24.9 33.4 26.4 31.3 22.7 3.7 0.15
4 Male 32.8 26.1 34.1 28.8 31.6 24.4 4.4 0.17
5 Male 33 25 33.7 26.8 32.4 23 3.8 0.15
6 Male 32.7 23.8 33.6 25.3 31.6 22.1 3.2 0.13
Mean 32.47 24.50 33.28 26.63 31.45 22.03 4.60 0.19
SD 0.92 1.30 0.91 1.35 0.80 1.80 1.35 0.06
Patients with sciatica (S)
1 Male 30.4 21.4 31.6 23 29.6 19.3 3.7 0.17
2 Male 33.8 23.6 34.2 25.5 32.5 21.8 3.7 0.16
3 Male 30.1 20.9 31.1 22.5 29.2 17.5 5 0.24
4 Male 33.7 25.4 34.2 26.5 33.1 24.7 1.8 0.07
5 Male 33.3 21.4 34.2 22.9 32.6 16.8 6.1 0.29
6 Male 31.2 21.1 31.8 22.8 30.6 17.9 4.9 0.23
7 Male 31.7 22.2 33.4 25.6 30.5 20.4 5.2 0.23
116 A. Cholewka et al.
123
but also in the case of SP. It follows from our studies that
temperature plots along as well as perpendicular to the spine
can be useful in the medical diagnosis also.
The statistical outlines were performed for all studied
groups. Different temperature parameters: mean, maximum
and minimum temperature characterizing the spinal col-
umn in the range from Th1/Th2 to L5/S1 were taken into
consideration (Table 1).
It follows from our analysis that mean temperature as
well as maximum or minimum temperature seem to be not
an adequate parameter because it depends on the number of
cryotherapy sessions taken, the patient state of health and
also the individual sensitivity of patient body cooling.
Therefore, the contrast temperature DT = T
max
- T
min
and
new relative contrast ratio Q = (DT)/(T
mean
) were
Table 1 continued
Temp./
°C
Gender T
mean
before
cryotherapy
T
mean
after
cryotherapy
T
max
before
cryotherapy
T
max
after
cryotherapy
T
min
before
cryotherapy
T
min
after
cryotherapy
DT = T
max
-
T
min
after
Q = DT/
T
mean
after
8 Male 34.4 23.5 34.9 26.7 33.4 21.5 5.2 0.22
9 Male 32.3 22.4 34 23.8 31.4 20.9 2.9 0.13
10 Male 33.1 22.3 33.7 24.3 32.4 20.9 3.4 0.15
11 Male 29.9 20.4 30.9 21.6 28.9 17.2 4.4 0.22
12 Male 32.5 20.3 33.8 21.9 31.5 19 2.9 0.14
13 Male 35.4 21.6 36.2 23.7 34.6 17.8 5.9 0.27
14 Female 31.5 22 32.5 23.5 30.2 19.2 4.3 0.20
15 Female 29.5 22 30.4 23.4 28.3 19.1 4.3 0.20
Mean 32.19 22.03 33.13 23.85 31.25 19.60 4.25 0.19
SD 1.77 1.34 1.66 1.58 1.84 2.13 1.19 0.06
Patients with ankylosing spondylitis (AS)
1 Male 32.9 27.1 33.4 28.1 32.4 25.2 2.8 0.10
2 Male 34.1 26.8 34.6 27.7 33.6 24.7 3 0.11
3 Male 33 24.7 33.9 26.9 32.1 23.6 3.3 0.13
4 Male 33.5 25 34 26.8 32.7 23.2 3.6 0.14
5 Male 32.3 24 34.4 26.8 30.2 19.4 7.4 0.31
6 Male 33.5 23.5 34.4 25.9 32.8 21.5 4.3 0.18
7 Male 33.6 23 34.2 24.9 32.8 19 5.9 0.26
8 Male 33.7 26.5 34.3 28.1 32.9 23.3 4.8 0.18
9 Male 33.2 22.7 34.1 25.7 32.6 20.5 5.2 0.23
10 Male 33 25.1 33.7 27.7 32.2 22.3 5.4 0.22
11 Male 33 25.9 33.5 28.2 32.4 24.7 3.6 0.14
12 Male 31.9 23.2 33.6 24.5 30.4 22.2 2.4 0.10
13 Male 30.6 21.5 32 23.4 29.5 19.3 4.1 0.19
14 Male 33.5 27.1 34.3 30.4 32.6 25.8 4.5 0.17
15 Male 32.6 22.8 33.6 25.2 31.5 20.2 5 0.22
16 Male 34.3 27 35.3 31.7 33.6 25.4 6.4 0.24
17 Male 33.8 26.4 34.5 29.3 33.2 25.1 4.1 0.16
18 Male 31.9 22.4 32.6 25 31.1 20 4.9 0.22
Mean 33.02 24.71 33.91 27.02 32.14 22.52 4.48 0.18
SD 0.91 1.87 0.76 2.14 1.16 2.35 1.30 0.06
Bold values refer to all statistical analysis
SP H AS S
Disease
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
ΔT = T
max
T
min
Mean SE SD
Fig. 5 Changes of T
max–min
obtained after whole body cryotherapy
for all studied groups of patients
Thermovision diagnostics in chosen spine diseases 117
123
introduced. Changes of DT calculated after whole body
cryotherapy for all studied groups of patients are shown in
Fig. 5. It is noteworthy that the difference between maxi-
mum and minimum temperature registered along the spine
is about 3 °C for a healthy (H) while for people with spine
pathological states (spondyloarthrosis—SP, sciatica—S
and ankylosing spondylitis—AS) it is markedly larger
(4.5 °C). Statistically significant differences of DT between
healthy people and patients with spine diseases were
obtained (p = 0.01).
Moreover one can see (Table 1) that the relative contrast
ratio Q increases about 50% when patients suffering from
spinal diseases are compared with healthy patients. This
parameter confirmed observed changes of temperature with
respect to mean temperature connected with the state of
spinal cord health.
In our opinion, in order to become independent of the
conditions of cryotherapy (body cooling), the contrast
temperature and relative contrast ratio should be more
proper in thermal characteristics of back pain diseases.
The aim of our investigation was also to monitor the
effects of cryotherapy on spinal diseases during whole
rehabilitation cycle.
Figure 6 shows temperature plots after cryotherapy in
the second, fifth and tenth day of cryotherapy cycle. The
anomal behaviour of temperature connected with diseases
states is observed during the whole therapy cycle. How-
ever, if we focus on the temperature plots considered as a
function of time (Fig. 6B), it is possible to get more
information. Deeper analysis suggests that a wide peak
connected with the inflammatory state in the lower lumbar
region observed in the second day of cryotherapy becomes
more clear and reveals the diseased vertebrates in details
(perhaps because of the shrink of adjacent areas). On the
other hand, the calculated factors DT, DT/T
mean
for each
patient as well as for statistical groups (AS and S) did not
show significant differences along with number of cryo-
therapy sessions although people reported decrease in pain
and increase in fitness [22, 23].
Conclusions
The results of our work showed that the thermal imaging
perform during whole body cryotherapy has a potential
diagnostics value in the case of SP, AS and sciatica
diseases.
The temperature plots performed along as well as per-
pendicular to lines in the spine as well as a temperature
contrast or a relative change of contrast ratio seems to be
useful in thermal diagnostics.
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... In relation to spine diseases, Cholewka, et al. 47 found that there are statistically significant differences between maximum and minimum temperature registered along the spine in individuals with spondylarthrosis (4.5 ºC) in relation to healthy people (about 3 ºC). These authors also found that images obtained after cryotherapy are clearer and reveal marked temperature differentiation that increases the potential diagnostic value of thermal imaging. ...
... These authors also found that images obtained after cryotherapy are clearer and reveal marked temperature differentiation that increases the potential diagnostic value of thermal imaging. In fact, cryotherapy seems to increase the potential for the diagnostics in these patients and in patients with ankylosing spondylitis, such as the use of wholebody cryotherapy shown in the study of Cholewka, et al. 47 . Wu, et al. ...
... It is not permitted to frame or use framing techniques to enclose any trademark, logo, or other proprietary information of the Publisher. Alfieri, et al. 44 Cholewka, et al. 47 Girasol, et al. 42 Samuel, et al. 45 Wu, et al. 48 Lasanen, et al. 43 Roy, et al. 46 ...
Article
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Introduction: Thermography is a non-invasive method to detect temperature changes on or near the surface of the body and may be used as a complementary method to screening and/or monitoring treatment effectiveness, despite its utility has not yet been fully verified. This systematic review evaluates the role of infrared thermography as a helpful outcome measure tool in subjects with back and neck syndromes. Materials and methods: A literature search was conducted across the National Library of Medicine (MEDLINE), Web of Science, and Scopus databases for studies that evaluated the role of infrared thermography as a helpful outcome measure tool in subjects with back and neck syndromes. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Results: The search strategy and selection criteria yielded 812 articles. From these, 268 duplicates were removed, and only 16 were in line with the aim of this review. Ultimately, only seven precisely fulfilled the inclusion and exclusion criteria and were included in the review. Discussion: According to the articles reviewed, thermography seems to give an objective notion of change in inflammatory activity, which can corroborate the usefulness of treatment or the improvement/worsening of the patient's symptoms. The overall quality of research was uneven in the study design, endpoint measures, and sample characteristics. Conclusions: The number of high-quality studies of the role of infrared thermography in patients with back and neck syndromes remains limited. More than a diagnostic tool, thermography can be an objective tool for monitoring the effectiveness of treatment by identifying deviations from a healthy state.
... With the help of thermovision, which is a noninvasive and painless method, we can observe thermal asymmetry between the breasts, contributing to the early detection of disturbing symptoms. The use of infrared imaging in the control of patients after radiotherapy is aimed at assessing the effects of treatment and observing the negative effects of ionizing radiation, which affect patient comfort [22][23][24][25][26][27][28][29]. ...
Article
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The aim of this study was to verify the changes in the temperature distribution within the breast at twelve months after the end of radiotherapy for breast cancer. The study included twenty-four women. The first test group consisted of twelve women who underwent breast mastectomy and qualified for radiotherapy according to standard medical treatment procedures. The second group included twelve healthy women. The tests were conducted before treatment with radiation therapy and two months, six months, nine months, and one year after the end of treatment. The mean temperature values changed depending on the time that had elapsed since the end of treatment. The highest temperature increase in all patients was observed six months after the end of radiotherapy. This research has confirmed that the assessment of temperature changes in the breast area after radiotherapy can evaluate the severity and lesions in the time course of the radiation reaction.
... In 2003, the National Cancer Institute developed the Common Terminology Criteria for Adverse Events (NCI CTCAE)-a five-point scale to monitor and evaluate the local radiation reaction. The negative effects caused by radiation therapy may persist from several weeks to even several years after the end of the treatment [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. ...
Article
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The aim of the study was to evaluate the temperature parameter of the breast area in patients undergoing radiotherapy at various intervals. The relationship between temperature changes on the patient’s skin and the time after the end of radiotherapy was studied. Measurements with a thermal imaging camera were performed in a group of twelve volunteers. Six of them were healthy women who did not have thermal asymmetry between the breasts, whereas six were diagnosed with breast cancer and underwent mastectomy due to the advanced stage of the disease. The patients were qualified for radiation therapy. Thermographic examinations were performed before treatment, two months later and then six months after the end of the treatment. Temperature differences between the healthy breasts and the treated areas were assessed. Additionally, the correlation between a patient’s skin temperature changes and the time after the end of radiotherapy was analyzed. The highest skin temperature increase (1.47 °C) was observed 6 months after the end of RT compared to the measurement before treatment. It seems that thermovision may bring a new tool for quantitative analyses of the temperature effects of radiotherapy.
... Temperature gradient changes (decrease and increase) on the skin surface or in the middle of the body are indicators of disease, allowing the evaluation of changes in metabolism and blood flow, especially in a superficial layer of the skin [10][11][12][13][14][15]. Several studies indicate that the symmetry of the extremities and torso will not have a temperature difference on the two sides along a dermatome or thermatome of more than 0.30 °C, and of no more than 0.90 °C on the forearms [16]. ...
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Temperature gradient changes on the surface of the skin or in the middle of the body are signs of a disease. The aim of this study is to develop quantitative models for the prediction of cumulative trauma disorders (CTDs) arising from highly repetitive activities, considering risk factors , such as age, gender, body mass index (BMI), blood pressure (BP), respiratory rate (RR), and heart rate, to prevent injuries in manufacturing factory operators. This research involved 19 individuals from the area of sanding and 14 individuals from the area of tolex in manufacturing factories who had their vital signs and somatometry taken, as well as thermal images of their hands in the dorsal and palmar areas; an evaluation by the OCRA method was also applied. Factors such as BP and heart rate were determined to significantly influence the injuries, but no strong association with BMI was found. Quadratic regression models were developed, the estimates of which were adequately adjusted to the variable (R 2 and R 2 adjusted > 0.70). When integrating the factors of the OCRA method to the generated models, a better fit was obtained (R 2 and adjusted R 2 > 0.80). In conclusion, the participants who present levels out of the normal range in at least one of the factors have high probabilities of developing injuries in their wrists.
... It is fully safe due to patients not being exposed to ionizing radiation. Thermal imaging brings some functioning information, indirectly connected with metabolism, so it may be used in screening tests or as a complement to existing and currently used diagnostic methods, like mammography or ultrasonography (USG) [8][9][10][11][12]. ...
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The study is focused on correlation of isotherms derived from thermal images with an isodoses describing treatment plan for patients with breast cancer treated by radiotherapy. The irradiated area covered the part of the body after mastectomy. The study included patients diagnosed with breast cancer who were qualified for radiotherapy treatment. All patients were monitored during each treatment week during the entire radiotherapy process. The measurements were made under strictly defined conditions. In the treatment planning system (TPS), the specific plan was created for each patient. Spatial dose distribution in the patient’s body was obtained and presented by the isodoses (lines connecting points with the same dose values). The following areas from the treatment planning system were plotted on the thermograms: target (tumor area) and isodose: 45 Gy, 40 Gy, 30 Gy, 20 Gy and 10 Gy. The obtained results indicated a high correlation between magnitude of the dose represented as the isodose and the temperature of the treated skin. Moreover, preliminary analysis showed a repeatable increase of the mean temperature in the irradiated area during the treatment.
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The analysis involved thermograms of the lower limbs of a patient suffering from symptomatic L-S segment discopathy with spinal root compression syndrome (symptomatic lumbar discopathy) qualified for surgical treatment. The thermograms were obtained using the Flir Ebx 50 camera. They were developed with the use of the software included with the Flir Ebx 50 camera, as well as the Origin Pro 2020 data analysis and graphing software. ROIs (Regions of Interest) were specified and analyzed in terms of temperature (average, maximum or minimum) temperature distributions, isotherms, and specified surface areas limited by selected isotherms. According to the analysis of the thermograms, the images obtained with Origin Pro 2020 enable a more advanced presentation of the temperature distribution, by taking into account the isotherms with selected temperatures and by calculating the area limited by a given isotherm (or between two isotherms) they allow to introduce an additional surface parameter related to specific isotherms. It provides additional information (parameter) in comparison with analogous ROIs on healthy and pathologic limbs in the same patient.
Chapter
This research reviews 18 scientific articles concerning the application of infrared thermography (IRT) in the mensuration of diagnostic studies of carpal tunnel syndrome (CTS). In addition, the proposed future challenges in this research area are identified. A review of articles is performed in databases such as PubMed, Scopus, EBSCO, ELSEVIER, Springer, and Oxford Academic using the keywords: carpal tunnel syndrome and (thermography OR infrared image OR thermal image). Its contents, journals publishing the topic, and the year of publication are reviewed, and graphs and cross tables are constructed. Using databases such as PubMed, Scopus, EBSCO, ELSEVIER, Springer, and Oxford Academic, 937 articles are identified, 37 of which were duplicates. The titles and abstracts of the remaining articles were reviewed, and 855 articles were deleted due to exclusion criteria. Eighteen articles were found written in foreign language, five were removed for not covering the topic (three reviews and two on liquid crystal thermography), and four were not available online. Finally, eighteen articles were selected for the full text review, from which 13 articles meet the CTS diagnostic classification and 5 consider the CTS studies. IRT is a reliable method in the diagnosis of CTS, mainly in the first stage. To improve diagnostic accuracy, it is recommended nerve conduction studies.
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The historical development of standards for medical thermal imaging in Europe, Northern America and the Far East is reported. Few studies were found in the literature which studied normal temperature values in selected body regions or focused on the symmetry of temperature distribution on the body surface. Reliabilty or reproducibility of temperature readings from infrared images was not investigated until the Nineties of the 20th Century. However, possible measurement errors due to oblique views on an object were identified in the Nineteen-Seventies. A set of views of body positions and regions of interest in these views was developed for the project of an atlas of normal infrared images of healthy subjects. A number of excperiments was performed to proof both the reproducibility of views for various body positions and the reliability of temperature readings from the defined regions of interest. Some modifications of the views on hands, knees and ankles wer made based on these studies. A high level of reproducibility of temperature readings was obtained for the selected shapes of regions of interest on hands, arms,the upper back, knees,ankles and feet. The Glamorgan Protocol, strictly applied for image recording and evaluation, increases the reproducibilty of findings from thermal images.
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Infra red imaging can only produce reliable and valid results if the technique follows established standards. In medical applications these standards are based on the physics of heat radiation and the physiology of thermoregulation of the human body. This paper describes the requirements for the location, setting up the equipment and the preparation of the human subject to be investigated.A list of references is given to support each part of the recommended procedure. Despite the fact that thermal imaging has been available for many years, there are still some applications of this technique which require more research.
Conference Paper
Infrared measurements have been used in investigations of the temperature response due to whole body cryotherapy. A wideness of the range of body temperatures observed in the thermograms directly after whole body cryotherapy is discussed due to increase of heat losses as well as metabolic process.
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The skin temperature response to whole body cryotherapy for a group of volunteers (6 female and 24 male) age 41.2 ± 13.3 has been studied by quantitative infrared thermography. The group consisted of 22 patients suffered from low back pain (5 female and 17 male in age 47.1 ± 10.1) and 8 health young people (1 female and 7 male in age 25 ± 4.1). Lower lumbar regions (selected areas and temperature profiles) were taken into consideration. A marked decrease of skin temperature after whole body cryotherapy was observed. These studies showed that cold impact doubles the range of temperature inside the region of interest. For this reason the slight changes of skin temperature before cryotherapy became more visible after whole body cryotherapy. The statistical analysis of temperature parameters (mean, maximum and minimum temperature) derived from thermal imaging after cryotherapy confirmed the significant differences between healthy men and patients with low back pain. Thermal evaluation showed that whole body cryotherapy induced significant changes of local blood flow dependent on tissue, degenerative processes and inflammatory states. An enhancement of the skin temperature profile could therefore increase the diagnostic sensitivity of infrared imaging in patients suffering from back pain.
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To compare the clinical course; laboratory and radiological features of women and men with ankylosing spondylitis (AS). Retrospective review of charts of 41 women and 41 men with AS (25 B27+ and 16 B27- in each group) individually matched for age at onset and disease duration. No differences were observed in the clinical picture in either sex, but the disease was less severe in women than in men with lesser duration of uveitis attacks, lower leukocyte counts (p < 0.05), lower levels of gamma-globulins (p < 0.05), and longer asymptomatic periods. At the end of the study, women had less restriction of spinal extension (p = NS), less sequelae of uveitis without significant visual loss (p = NS), required fewer hip replacements, had less frequency of bamboo spine (p < 0.02), and better functional class (p < 0.0027) than men. There are no significant clinical or radiographic differences between women and men with AS. However, the disease was more severe in men and these features may be due to sexual dimorphism.
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Cryotherapy increases the threshold of pain and induces physiological changes. It influences hemodynamics (reduction of skin- and muscle temperature through vasoconstriction), metabolism (reduction of ischemia due to hypoxia), and neural control (reduction of nerve conduction velocity and muscle tone). Cryotherapy is indicated mainly in locomotor system related pain. Such pain can be induced by degenerative changes, postoperatively, and during mobilisation of contracted joints. Cryotherapy may be used as short term therapy (less than 15 min) as well as long term therapy (more than 20 min). For maximal efficacy the intensity of application as well as the application medium must be considered. Due to biorhythm, cold application seems to be more effective in the afternoon.