187 research outputs found

    Advances in Breast Thermography

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    Thermography‐based breast cancer screening has several advantages as it is non-contact, non-invasive and safe. Many clinical trials have shown its effectiveness to detect cancer earlier than any other modality. Historically, thermography has only been used as an adjunct modality due to the high expertise required for manual interpretation of the thermal images and high false‐positive rates otherwise found in general use. Recent developments in thermal sensors, image capture protocols and computer‐aided software diagnostics are showing great promise in making this modality a mainstream cancer screening method. This chapter describes some of these advances in breast thermography and computer‐aided diagnostics that are poised to improve the quality of cancer care

    Biosensors: 10th Anniversary Feature Papers

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    Biosensors are analytical devices used for the detection of a chemical substance, or analyte, which combines a biological component with a physicochemical detector. Detection and quantification are based on the measurement of the biological interactions. The biological element of a biosensor may consist of tissues, microorganisms, organelles, cell receptors, enzymes, antibodies and nucleic acids. These devices have been shown to have a wide range of applications in a vast array of fields of research, including environmental monitoring, food analysis, drug detection and health and clinical assessment, and even security and safety. The current Special Issue, “Biosensors: 10th Anniversary Feature Papers”, addresses the existing knowledge gaps and aids the advancement of biosensing applications, in the form of six peer-reviewed research and review papers, detailing the most recent and innovative developments of biosensors

    A Patient-Specific Infrared Imaging Technique for Adjunctive Breast Cancer Screening: A Clinical and Simulation - Based Approach

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    Breast cancer is currently the most prevalent form of cancer in women with over 266,000 new diagnoses every year. The various methods used for breast cancer screening range in accuracy and cost, however there is no easily reproducible, reliable, low-cost screening method currently available for detecting cancer in breasts, especially with dense tissue. Steady-state Infrared Imaging (IRI) is unaffected by tissue density and has the potential to detect tumors in the breast by measuring and capturing the thermal profile on the breast surface induced by increased blood perfusion and metabolic activity in a rapidly growing malignant tumor. The current work presents a better understanding of IRI as an accurate breast cancer detection modality. A detailed study utilizing IRI-MRI approach with clinical design and validation of an elaborate IRI-Mammo study are presented by considering patient population, clinical study design, image interpretation, and recommended future path. Clinical IRI images are obtained in this study and an ANSYS-based modeling process developed earlier at RIT is used to localize and detect tumor in seven patients without subjective human interpretation. Further, the unique thermal characteristics of tumors that make their signatures distinct from benign conditions are identified. This work is part of an ongoing multidisciplinary collaboration between a team of thermal engineers and numerical modelers at the Rochester Institute of Technology and a team of clinicians at the Rochester General Hospital. The following components were developed to ensure valid experimentation while considering ethical considerations: IRB documentation, patient protocols, an image acquisition system (camera setup and screening table), and the necessary tools needed for image analysis without human interpretation. IRI images in the prone position were obtained and were used in accurately detecting the presence of a cancerous tumor in seven subjects. The size and location of tumor was also confirmed within 7 mm as compared to biopsy-proven pathology information. The study indicates that the IRI-Mammo approach has potential to be a highly effective adjunctive screening tool that can improve the breast cancer detection rates especially for subjects with dense breast tissue. This method is low cost, no-touch, radiation-free and highly portable, making it an attractive candidate as a breast cancer detection modality. Further, the developed method provided insight into infrared features corresponding to other biological images, pathology reports and patient history

    Infrared Thermography for the Assessment of Lumbar Sympathetic Blocks in Patients with Complex Regional Pain Syndrome

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    [ES] El síndrome de dolor regional complejo (SDRC) es un trastorno de dolor crónico debilitante que suele afectar a una extremidad, y se caracteriza por su compleja e incomprendida fisiopatología subyacente, lo que supone un reto para su diagnóstico y tratamiento. Para evitar el deterioro de la calidad de vida de los pacientes, la consecución de un diagnóstico y tratamiento tempranos marca un punto de inflexión. Entre los diferentes tratamientos, los bloqueos simpáticos lumbares (BSLs) tienen como objetivo aliviar el dolor y reducir algunos signos simpáticos de la afección. Este procedimiento intervencionista se lleva a cabo inyectando anestesia local alrededor de los ganglios simpáticos y, hasta ahora, se realiza frecuentemente bajo el control de diferentes técnicas de imagen, como los ultrasonidos o la fluoroscopia. Dado que la termografía infrarroja (TIR) ha demostrado ser una herramienta eficaz para evaluar la temperatura de la piel, y teniendo en cuenta el efecto vasodilatador que presentan los anestésicos locales inyectados, se ha considerado el uso de la IRT para la evaluación de los BSLs. El objetivo de esta tesis es, estudiar la capacidad de la TIR como una técnica complementaria para la evaluación de la eficacia en la ejecución de los BSLs. Para cumplir este objetivo, se han realizado tres estudios implementando la TIR en pacientes diagnosticados de SDRC de miembros inferiores sometidos a BSLs. El primer estudio se centra en la viabilidad de la TIR como herramienta complementaria para la evaluación de la eficacia ejecución de los BSLs. Cuando se realizan los BSLs, la colocación correcta de la aguja es crítica para llevar realizar el procedimiento técnicamente correcto y, en consecuencia, para lograr los resultados clínicos deseados. Para verificar la posición de la aguja, tradicionalmente se han utilizado técnicas de imagen, sin embargo, los BSLs bajo control fluoroscópico no siempre aseguran su exacta ejecución. Por este motivo, se han aprovechado las alteraciones térmicas inducidas por los anestésicos locales y se han evaluado mediante la TIR. Así, cuando en las imágenes infrarrojas se observaron cambios térmicos en la planta del pie afectado tras la inyección de lidocaína, se consideró que el BSL era exitoso. El segundo estudio trata del análisis cuantitativo de los datos térmicos recogidos en el entorno clínico a partir de diferentes parámetros basados en las temperaturas extraídas de ambos pies. Según los resultados, para predecir adecuadamente los BSLs exitosos, se deberían analizar las temperaturas de las plantas de los pies durante los primeros cuatro minutos tras la inyección del anestésico local. Así, la aplicación de la TIR en el entorno clínico podría ser de gran ayuda para evaluar la eficacia de ejecución de los BSLs mediante la evaluación de las temperaturas de los pies en tiempo real. Por último, el tercer estudio aborda el análisis cuantitativo mediante la implementación de herramientas de machine learning (ML) para evaluar su capacidad de clasificar automáticamente los BSLs. En este estudio se han utilizado una serie de características térmicas extraídas de las imágenes infrarrojas para evaluar cuatro algoritmos de ML para tres momentos diferentes después del instante de referencia (inyección de lidocaína). Los resultados indican que los cuatro modelos evaluados presentan buenos rendimientos para clasificar automáticamente los BSLs entre exitosos y fallidos. Por lo tanto, la combinación de parámetros térmicos junto con de clasificación ML muestra ser eficaz para la clasificación automática de los procedimientos de BSLs. En conclusión, el uso de la TIR como técnica complementaria en la práctica clínica diaria para la evaluación de los BSLs ha demostrado ser totalmente eficaz. Dado que es un método objetivo y relativamente sencillo de implementar, puede permitir que los médicos especialistas en dolor identifiquen los bloqueos realizados fallidos y, en consecuencia, puedan revertir esta situación.[CA] La síndrome de dolor regional complex (SDRC) és un trastorn de dolor crònic debilitant que sol afectar una extremitat, i es caracteritza per la seua complexa i incompresa fisiopatologia subjacent, la qual cosa suposa un repte per al seu diagnòstic i tractament. Per a evitar la deterioració de la qualitat de vida dels pacients, la consecució d'un diagnòstic i tractament primerencs marca un punt d'inflexió. Entre els diferents tractaments , els bloquejos simpàtics lumbars (BSLs) tenen com a objectiu alleujar el dolor i reduir alguns signes simpàtics de l'afecció. Aquest procediment intervencionista es duu a terme injectant anestèsia local al voltant dels ganglis simpàtics i, fins ara, es realitza freqüentment sota el control de diferents tècniques d'imatge, com els ultrasons o la fluoroscopia. Atés que la termografia infraroja (TIR) ha demostrat ser una eina eficaç per a avaluar la temperatura de la pell, i tenint en compte l'efecte vasodilatador que presenten els anestèsics locals injectats, s'ha considerat l'ús de la TIR per a l'avaluació dels BSLs. L'objectiu d'aquesta tesi és, estudiar la capacitat de la TIR com una tècnica complementària per a l'avaluació de l'eficàcia en l'execució dels BSLs. Per a complir aquest objectiu, s'han realitzat tres estudis implementant la TIR en pacients diagnosticats de SDRC de membres inferiors sotmesos a BSLs. El primer estudi avalua la viabilitat de la TIR com a eina complementària per a l'analisi de l'eficàcia en l'execució dels BSLs. Quan es realitzen els BSLs, la col·locació correcta de l'agulla és crítica per a dur a terme el procediment tècnicament correcte i, en conseqüència, per a aconseguir els resultats clínics desitjats. Per a verificar la posició de l'agulla, tradicionalment s'han utilitzat tècniques d'imatge, no obstant això, els BSLs baix control fluoroscòpic no sempre asseguren la seua exacta execució. Per aquest motiu, s'han aprofitat les alteracions tèrmiques induïdes pels anestèsics locals i s'han avaluat mitjançant la TIR. Així, quan en les imatges infraroges es van observar canvis tèrmics en la planta del peu afectat després de la injecció de lidocaIna, es va considerar que el BSL era exitós. El segon estudi tracta de l'anàlisi quantitativa de les dades tèrmiques recollides en l'entorn clínic a partir de diferents paràmetres basats en les temperatures extretes d'ambdós peus. Segons els resultats, per a predir adequadament l'execució exitosa d'un BSL, s'haurien d'analitzar les temperatures de les plantes dels peus durant els primers quatre minuts després de la injecció de l'anestèsic local. Així, l'implementació de la TIR en l'entorn clínic podria ser de gran ajuda per a avaluar l'eficàcia d'execució dels BSLs mitjançant l'avaluació de les temperatures dels peus en temps real. El tercer estudi aborda l'anàlisi quantitativa mitjançant la implementació d'eines machine learning (ML) per a avaluar la seua capacitat de classificar automàticament els BSLs. En aquest estudi s'han utilitzat una sèrie de característiques tèrmiques extretes de les imatges infraroges per a avaluar quatre algorismes de ML per a tres moments diferents després de l'instant de referència (injecció de lidocaïna). Els resultats indiquen que els quatre models avaluats presenten bons rendiments per a classificar automàticament els BSLs en exitosos i fallits. Per tant, la combinació de paràmetres tèrmics juntament amb models de classificació ML mostra ser eficaç per a la classificació automàtica dels procediments de BSLs. En conclusió, l'ús de la TIR com a tècnica complementària en la pràctica clínica diària per a l'avaluació dels BSLs ha demostrat ser totalment eficaç. Atés que és un mètode objectiu i relativament senzill d'implementar, pot ajudar els metges especialistes en dolor a identificar els bloquejos realitzats fallits i, en conseqüència, puguen revertir aquesta situació.[EN] Complex regional pain syndrome (CRPS) is a debilitating chronic pain condition that usually affects one limb, and it is characterized by its misunderstood underlying pathophysiology, resulting in both challenging diagnosis and treatment. To avoid the patients' impairment quality of life, the achievement of both an early diagnosis and treatment marks a turning point. Among the different treatment approaches, lumbar sympathetic blocks (LSBs) are addressed to alleviate the pain and reduce some sympathetic signs of the condition. This interventional procedure is performed by injecting local anaesthetic around the sympathetic ganglia and, until now, it has been performed under different imaging techniques, including the ultrasound or the fluoroscopy approaches. Since infrared thermography (IRT) has proven to be a powerful tool to evaluate skin temperatures and taking into account the vasodilatory effects of the local anaesthetics injected in the LSB, the use of IRT has been considered for the LSBs assessment. Therefore, the purpose of this thesis is to evaluate the capability of IRT as a complementary assessment technique for the LSBs procedures performance. To fulfil this aim, three studies have been conducted implementing the IRT in patients diagnosed with lower limbs CRPS undergoing LSBs. The first study focuses on the feasibility of IRT as a complementary assessment tool for LSBs performance, that is, for the confirmation of the proper needle position. When LSBs are performed, the correct needle placement is critical to carry out the procedure technically correct and, consequently, to achieve the desired clinical outcomes. To verify the needle placement position, imaging techniques have traditionally been used, however, LSBs under radioscopic guidance do not always ensure an exact performance. For this reason, the thermal alterations induced by the local anaesthetics, have been exploited and assessed by means of IRT. Thus, the LSB procedure was considered successfully performed when thermal changes within the affected plantar foot were observed in the infrared images after the lidocaine injection. The second study deals with the quantitative analysis of the thermal data collected in the clinical setting through the evaluation of different temperature-based parameters extracted from both feet. According to the results, the proper LSB success prediction could be achieved in the first four minutes after the block through the evaluation of the feet skin temperatures. Therefore, the implementation of IRT in the clinical setting might be of great help in assessing the LSBs performance by evaluating the plantar feet temperatures in real time. Finally, the third study addresses the quantitative analysis by implementing machine learning (ML) tools to assess their capability to automatically classify LSBs. In this study, a set of thermal features retrieved from the infrared images have been used to evaluate four ML algorithms for three different moments after the baseline time (lidocaine injection). The results indicate that all four models evaluated present good performance metrics to automatically classify LSBs into successful and failed. Therefore, combining infrared features with ML classification models shows to be effective for the LSBs procedures automatic classification. In conclusion, the use of IRT as a complementary technique in daily clinical practice for LSBs assessment has been evidenced entirely effective. Since IRT is an objective method and it is not very demanding to perform, it is of great help for pain physicians to identify failed procedures, and consequently, it allow them to reverse this situation.Cañada Soriano, M. (2022). Infrared Thermography for the Assessment of Lumbar Sympathetic Blocks in Patients with Complex Regional Pain Syndrome [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/181699TESI

    Water-filtered Infrared A (wIRA) Irradiation

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    The aim of this open access book is to provide a unique, timely, critical and comprehensive compilation of more than 30 years of robust international experimental and clinical research related to the basic science and therapeutic application of water-filtered infrared-A (wIRA) and hyperthermia in oncology, psychiatry (depression), musculoskeletal disorders, dermatology, infectiology, and surgery. This is an internationally absolutely unique attempt which publication is timely and of great interest in medical as well as in natural sciences. The aim is to enhance communication and advance the use of heat therapy for patient benefit, and to generate an environment in which anyone with an interest in hyperthermia can discuss, collaborate, network, and share events and resources. Productive dialogue and discussion among scientists and practitioners on issues relating to hyperthermia therapy is essential, especially relating to thermal transmission by water-filtered infrared-A (wIRA). The specificity and advantage of this technology is its tolerance by tissue, and its penetration of up to 3 cm allows the delivery of high heat dosages that are relevant across multiple clinical indications. Currently, wIRA is being applied in Austria, Germany, Portugal, Switzerland, The Netherlands, UK and the USA. The authors’ hope is that its use will increase in these countries, and also expand into others. This book will be an invaluable tool for oncologists, surgeons, dermatologists as well as physiotherapists

    Water-Filtered Infrared A (wIRA) Irradiation: Novel Treatment Options for Chlamydial Infections

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    wIRA has been shown to reduce extracellular chlamydial forms and intracellular chlamydial inclusions in different cell culture infection models, and similarly on different human or animal chlamydial species. Repeated wIRA applications increase the efficacy of treatment in vitro, and in vivo in a guinea pig ocular model of inclusion conjunctivitis. The guinea pig model reflects the human ocular disease trachoma, the most common cause of infectious blindness worldwide which is caused by ocular strains of Chlamydia trachomatis. In this model, ocular wIRA treatment reduces conjunctival chlamydial load and ocular pathology. First insights into the mechanisms of anti-chlamydial activity indicate the involvement of both thermal and non-thermal effects. Interestingly, wIRA treatment of non-infected cells renders them more resistant to subsequent chlamydial infection, suggesting cell-related mechanisms that might involve cytochrome C. Further studies envisage the refinement of wIRA treatment protocols, the enhancement of anti-chlamydial activity by adding photodynamic substances, and characterization of the mechanisms underlying the therapeutic benefit of wIRA

    Laser doppler perfusion imaging of the normal and diseased vulva.

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    Vulval lichen sclerosus (LS) and high-grade intraepithelial neoplasia (VIN 3) are two common and distressing diseases. Significant morbidity is caused by symptoms of persistent pruritus and surgical treatment of skin areas suspicious of malignancy. The risk of developing cancer in a background of LS and VIN 3 is poorly defined. The methods currently available for clinical assessment of the vulva are limited. There is abundant research on the application of the LASER Doppler technique - laser Doppler Flowmetry (LDF) - showing changes in perfusion within the small blood vessels of the skin as a useful parameter for more accurate disease classification. There is also research on immunohistochemical microvessel density (MVD) studies showing increases in blood supply in tissues prone to develop cancer or as a prognostic marker of cancer outcome. The Laser Doppler perfusion imager (LDPI) provides a rapid, real time, non-invasive and non-contact method to measure skin blood flow in an area as opposed to a single point by the LDF, making the LDPI more suitable for application to the vulva. This thesis reports for the first time, the application of the LDPI to the vulva. Initially the LDPI was applied to the clinically normal vulva to study perfusion variance related to menstrual cycle, age and local skin temperature provocation. The application was then extended to vulval disease, LS and VIN 3, and validated against morphological differences in MVD. The LDPI and MVD studies suggest that in VIN 3 there is an actual increase in skin perfusion. In LS the situation is more complex and suggests that the LDPI measured perfusion at a greater depth than the MVD. Studies on base line perfusion variance of vulval LS to topical therapy show that there is no overall difference in baseline perfusion in spite of symptom improvement. Temperature provocation studies suggest differences in skin blood flow response in diseased compared to the normal vulva

    Water-filtered Infrared A (wIRA) Irradiation

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    The aim of this open access book is to provide a unique, timely, critical and comprehensive compilation of more than 30 years of robust international experimental and clinical research related to the basic science and therapeutic application of water-filtered infrared-A (wIRA) and hyperthermia in oncology, psychiatry (depression), musculoskeletal disorders, dermatology, infectiology, and surgery. This is an internationally absolutely unique attempt which publication is timely and of great interest in medical as well as in natural sciences. The aim is to enhance communication and advance the use of heat therapy for patient benefit, and to generate an environment in which anyone with an interest in hyperthermia can discuss, collaborate, network, and share events and resources. Productive dialogue and discussion among scientists and practitioners on issues relating to hyperthermia therapy is essential, especially relating to thermal transmission by water-filtered infrared-A (wIRA). The specificity and advantage of this technology is its tolerance by tissue, and its penetration of up to 3 cm allows the delivery of high heat dosages that are relevant across multiple clinical indications. Currently, wIRA is being applied in Austria, Germany, Portugal, Switzerland, The Netherlands, UK and the USA. The authors’ hope is that its use will increase in these countries, and also expand into others. This book will be an invaluable tool for oncologists, surgeons, dermatologists as well as physiotherapists
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