Evolution of Imaging in Breast Cancer.

The following topics are discussed in this article. A historical review of the evolution of breast cancer imaging from thermography through digital breast tomosynthesis, molecular breast imaging, and advanced breast magnetic resonance imaging. Discussion of multiple clinical trials, their strengths, and weaknesses. Historical perspective on the Mammography Quality Standards Act and its relationship with development and implementation of the Breast Imaging-Reporting and Data System (BI-RADS).

Laser-induced thermal therapy for tumor ablation.

Image-guided ablation of tumors is assuming an increasingly important role in many oncology services as a minimally invasive alternative to conventional surgical interventions for patients who are not good candidates for surgery. Laser-induced thermal therapy (LITT) is a percutaneous tumor-ablation technique that utilizes high-power lasers placed interstitially in the tumor to deliver therapy. Multiple laser fibers can be placed into the treatment volume and, unlike other interstitial heating techniques, can be fired simultaneously to rapidly treat large volumes of tissue. Modern systems utilize small, compact, high-power laser diode systems with actively cooled applicators to help keep tissue from charring during procedures. Additionally, because this approach to thermal therapy is easily made magnetic resonance (MR) compatible, the incorporation of magnetic resonance imaging (MRI) for treatment planning, targeting, monitoring, and verification has helped to expand the number of applications in which LITT can be applied safely and effectively. We provide an overview of the clinically used technology and algorithms that provide the foundations for current state-of-the-art MR-guided LITT (MRgLITT), including procedures in the brain, liver, bone, and prostate as examples. In addition to advances in imaging and delivery, such as the incorporation of nanotechnology, next-generation MRgLITT systems are anticipated to incorporate an increasing presence of in silico-based modeling of MRgLITT procedures to provide human-assisted computational tools for planning, MR model-assisted temperature monitoring, thermal-dose assessment, and optimal control.

Toward the design of a wearable system for contact thermography in telemedicine.

Thermal imaging of the skin has been used for several decades for monitoring of temperature distribution of human skin for the detection of thermal abnormalities indicating pathologies (malignancies, inflammation, infection, and vascular, dermatological, and rheumatic disorders). Literature has shown that to detect and monitor the thermal abnormalities related to pathologic conditions, there is a need to extend acquisition over 8, 12, 16, or 24 hours. A wearable device is strongly needed in contact thermography to reach the objective of long-term monitoring of contact thermography, especially in telemedicine applications. A wearable system has been designed and constructed that allows the continuous thermographic monitoring of a skin region at the point of affixation. Measurement allowed by this system is direct and not hampered by the influence of the environment--as with IR thermography--nor by the geometry of skin surface (curvatures, roughness) thanks to the flexible adaptation of the sensing head to the surface. The validation of the system embedded in a pilot preliminary telemedicine application was successful. The next step will be the wide focusing and adaptation to telemedicine clinical applications to assess the response to the chemotherapy and tune the therapy at home of the breast cancer or the response to the inflammation care.

Smartphone-Based Device in Exotic Pet Medicine.

This article reviews the use of the smartphone in exotic pet medicine. The mobile app is the most instinctive use of the smartphone; however, there are very limited software dedicated to the exotic pet specifically. With an adapter, the smartphone can be attached to a regular endoscope and acts as a small endoscopic unit. Additional devices, such as infrared thermography or ultrasound, can be connected to the smartphone through the micro-USB port. The medical use of the smartphone is still in its infancy in veterinary medicine but can bring several solutions to the exotic pet practitioner and improve point-of-care evaluation.

Potential for thermal damage to the blood-brain barrier during craniotomy: implications for intracortical recording microelectrodes.

OBJECTIVE: Our objective was to determine how readily disruption of the blood-brain barrier (BBB) occurred as a result of bone drilling during a craniotomy to implant microelectrodes in rat cortex. While the phenomenon of heat production during bone drilling is well known, practices to evade damage to the underlying brain tissue are inconsistently practiced and reported in the literature. APPROACH: We conducted a review of the intracortical microelectrode literature to summarize typical approaches to mitigate drill heating during rodent craniotomies. Post mortem skull-surface and transient brain-surface temperatures were experimentally recorded using an infrared camera and thermocouple, respectively. A number of drilling conditions were tested, including varying drill speed and continuous versus intermittent contact. In vivo BBB permeability was assayed 1 h after the craniotomy procedure using Evans blue dye. MAIN RESULTS: Of the reviewed papers that mentioned methods to mitigate thermal damage during craniotomy, saline irrigation was the most frequently cited (in six of seven papers). In post mortem tissues, we observed increases in skull-surface temperature ranging from +3 °C to +21 °C, dependent on drill speed. In vivo, pulsed-drilling (2 s-on/2 s-off) and slow-drilling speeds (1000 r.p.m.) were the most effective methods we studied to mitigate heating effects from drilling, while inconclusive results were obtained with saline irrigation. SIGNIFICANCE: Neuroinflammation, initiated by damage to the BBB and perpetuated by the foreign body response, is thought to play a key role in premature failure of intracortical recording microelectrodes. This study demonstrates the extreme sensitivity of the BBB to overheating caused by bone drilling. To avoid damage to the BBB, the authors recommend that craniotomies be drilled with slow speeds and/or with intermittent drilling with complete removal of the drill from the skull during 'off' periods. While saline alone was ineffective at preventing overheating, its use is still recommended to remove bone dust from the surgical site and to augment other cooling methods.

[Remote infrared thermography: achievements, current potentials, and perspectives].

The article presents obtained results on using remote infrared thermograph in medical practice in Ukraine. It was shown that appearance of domestic thermographs with matrix photoreceiver enhances considerably an area of their use. New results related to diagnosis of a patient's state were obtained. Taking into account that this method is harmless, not difficult to perform, allows carrying out diagnostics many times during treatment and appearance of a new type of thermographs with high temperature sensitivity, it is necessary to renew the use of remote infrared thermography in medical practice in Ukraine.

MRI-guided focused ultrasound: methodology and applications.

Focused ultrasound is very well suited for inducing noninvasive local hyperthermia. Since magnetic resonance imaging (MRI) may be employed to obtain real-time temperature maps noninvasively the combination of these two technologies offers great advantages specifically aimed toward oncological studies. Real-time identification of the target region and accurate control of the temperature evolution during the treatment has now become possible. Thermal ablation of pathological tissue, local drug delivery using thermosensitive micro-carriers and controlled transgene expression using thermosensitive promoters have recently been demonstrated with this unique technology. Based on these experiments combined focused ultrasound and MRI thermometry holds promise for future oncological diagnostics and treatment. In this paper, we review some of the recent methodological developments as well as experimental and first clinical studies using this approach.

A perspective on medical infrared imaging.

Since the early days of thermography in the 1950s, image processing techniques, sensitivity of thermal sensors and spatial resolution have progressed greatly, holding out fresh promise for infrared (IR) imaging techniques. Applications in civil, industrial and healthcare fields are thus reaching a high level of technical performance. The relationship between body temperature and disease was documented since 400 bc. In many diseases there are variations in blood flow, and these in turn affect the skin temperature. IR imaging offers a useful and non-invasive approach to the diagnosis and treatment (as therapeutic aids) of many disorders, in particular in the areas of rheumatology, dermatology, orthopaedics and circulatory abnormalities. This paper reviews many usages (and hence the limitations) of thermography in biomedical fields.

The noninvasive laboratory: history and future of thermography.

A brief history of thermography and recent developments in instrumentation have been reviewed. Important applications are related to thrombophlebitis, the cerebral circulation, peripheral arterial abnormalities and medical-legal situations.

The noninvasive laboratory--history and future of thermography.

A brief history of thermography and recent developments in instrumentation have been reviewed. Important applications are related to thrombophlebitis, the cerebral circulation, peripheral arterial abnormalities and medical-legal situations.

Efectos agudos de la práctica del bádminton sobre la temperatura superficial de los miembros inferiores / Acute effects of badminton practice on the surface temperature of lower limbs

Introducción: El objetivo fue evaluar el efecto de un entrenamiento de bádminton sobre la temperatura superficial de los miembros inferiores y las posibles asimetrías derivadas de la unilateralidad del deporte. Material y método: 19 jugadores de bádminton participaron en el estudio (Edad: 34,4±14,1 años, Estatura: 168,1±7,8 cm, Masa corporal: 66,2±13,9 kg). Cada jugador fue analizado antes y después de realizar un entrenamiento de bádminton estandarizado de 2 horas. Para registrar la temperatura corporal se utilizó una cámara termográfica VARIOCAM® modelo HR. Se tomaron las imágenes de la parte anterior y posterior de los miembros inferiores divididos en tres zonas (muslo, rodilla y pierna). Resultados: La temperatura media del miembro inferior dominante fue mayor después del entrenamiento en la zona anterior de la rodilla (pre=31,52±0,91 o C vs post=32,15±0,51 o C; p=0,003) y en la zona anterior de la pierna (pre=32,10±0,75 o C vs post=32,81±0,73 o C; p<0,001). En el miembro inferior no dominante se registró un incremento después del entrenamiento en la temperatura media en la zona anterior del muslo (pre=32,15±0,85 o C vs post=32,50±0,52 o C; p=0,018), en la zona anterior de la rodilla (pre=31,55±0,91 o C vs post=32,26±0,56 o C; p=0,001), en la zona anterior de la pierna (pre=32,22±0,76 o C vs post=32,80±0,74 o C; p<0.001) y en la zona posterior de la pierna (pre=32,13±0,69 o C vs post=32,50±0,65 o C; p=0,006). No se encontraron diferencias en la temperatura superficial entre el miembro inferior dominante y no dominante en ningún instante ni zona analizada. Conclusiones: Los resultados muestran que las regiones anteriores de la rodilla y de la pierna en ambos miembros inferiores y la región anterior del muslo y posterior de la pierna en el miembro inferior no dominante son las que muestran un mayor incremento de temperatura tras un entrenamiento de bádminton debiendo ser en ellas donde recaiga mayor atención en el periodo de recuperación y en la vuelta a la calma después del entrenamiento

Introduction: The objective was to evaluate the effect of badminton training on the skin temperature of lower limbs and the possible asymmetries derived from the one-sidedness of the sport. Material and method: 19 badminton players participated in the study (Age: 34.4±14.1 years, Height: 168.1±7.8 cm, Body mass: 66.2±13.9 kg). Each player was tested before and after performing a 2-hour standardized badminton workout. To record body temperature, a VARIOCAM® HR model thermographic camera was used. The images of the anterior and posterior parts of the lower limbs were divided into three zones (thigh, knee and leg). Results: The mean temperature of the dominant lower limb was higher after training in the anterior knee (pre=31.52±0.91 o C vs post=32.15±0.51 o C, P=0.003) and in the anterior leg=32.10±0.75 o C vs post=32.81±0.73 o C, P<0.001) In the non-dominant lower limb an increase after training was recorded in the medial temperature in the anterior thigh area (pre=32.15±0.85 o C vs post=32.50±0.52 o C, P=0.018), in the anterior area of the knee (pre=31.55±0.91 o C vs post=32.26±0.56 o C, P<0.001), in the anterior area of the leg (pre=32.22±0.76 o C vs post=32.80±0.74 o C, P<0.001), posterior of the leg (pre=32.13±0.69 o C vs post=32.50± 0.65 o C, P=0.006). No differences were found in the surface temperature between the dominant and non-dominant lower limbs at any instant or in the analyzed area. Conclusions: The results show that the anterior regions of the knee and leg in both lower limbs and the anterior region of the thigh and posterior leg in the non-dominant lower limb are those that show a greater increase in temperature after a training of badminton should be where they focus more attention in the recovery period and in the return to calm after training

Developments in near-infrared-guided hepatobiliary, pancreatic and other upper gastrointestinal surgery.

With the development of near-infrared (NIR) technology, real-time utility of NIR and its fluorophores has gained vast interest among surgeons of various sub-disciplines. The purpose of this review is to assess and explore the most recent developments in NIR-guided surgery in an upper gastrointestinal (UGI) surgical setting. Queries of PubMed and Medline literature databases was performed for experimental and clinical studies relevant to NIR use in the context of UGI surgery. NIR-guided UGI surgeries have been reported to be valuable in: (1) esophageal anastomosis; (2) sentinel lymph node biopsy in gastric cancer; (3) detection of liver and pancreatic tumors; and (4) detection of extra bile duct and bile duct injuries. Although NIR technology has shown tremendous promise in UGI surgery, its full clinical translation and wider adaptation remains to be seen.