Hot spot: the thermal imager will indicate the dangerous condition of the patient after surgery

For the first time in the country, Russian doctors began using thermal imagers in clinical practice to monitor patients after surgery. These devices help in the diagnosis of the inflammatory process and in the assessment of blood supply. It is absolutely painless for the patient. The doctor sees a color image on the screen on which the body temperature looks like a color palette — from red to blue-violet and determines the presence of pathological processes on the spectrum. In some cases, the technique will avoid CT scans, blood tests and X-rays, or it will reveal the need for these procedures, experts told Izvestia.

How thermal imagers are used in medicine

Doctors of the Center for Medical Rehabilitation of the First Moscow State Medical University named after I.M. Sechenov began using a thermal imager in clinical practice, the university told Izvestia. This device will help in the diagnosis of the inflammatory process and the assessment of blood supply and will serve to monitor patients after surgery in dynamics.

Photo: Sechenov University

According to the scientists, thermal imaging diagnostics has been used in medicine for scientific purposes for several years. But as a clinical diagnostic method that stands on a par with other instrumental imaging methods, it has been used for the first time right now.

— Blood tests, X—rays, CT scans are the gold standard of diagnostics, the accuracy and information content of which doctors do not question. Nevertheless, blood sampling causes discomfort in some patients, and X-rays and CT scans suggest radiation exposure. In some cases, these procedures can be avoided by performing a thermal imaging assessment at a preliminary stage. The thermal imager is absolutely painless for the patient and easy to use — you need to point its "lens" and take a picture," said Alexey Repetyuk, head of the Medical diagnostic department at the Sechenov University Medical Rehabilitation Center.

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The doctor sees a color image on the screen, where the patient's body temperature is displayed as a color palette — from red to blue-purple. Inflammatory processes correspond to orange and red hues, and areas with insufficient blood supply correspond to the cold colors of the spectrum. A similar visualization is used for strokes: the affected areas (individual parts of an arm or leg, or larger areas of the body) are displayed as areas with reduced microcirculation with clear boundaries. During rehabilitation, these boundaries shift, which allows the doctor to evaluate the effectiveness of the recovery methods used, the university noted.

Photo: Sechenov University

The system consists of several elements: a crystal that is responsible for taking pictures, software interprets the image into a conclusion for a doctor, a laptop or a computer.

— The main working part of the device is a crystal and software made entirely in Russia. This is a unique technology that gives the clinician a completely new layer of information that allows them to predict the development of the clinical picture and decide on further actions. The range of applications ranges from the diagnosis of the inflammatory process to the assessment of microcirculatory and vascular pathology," said Oleg Vasiliev, Professor of the Department of Sports Medicine and Medical Rehabilitation at Sechenov University.

Thermal imager as an indispensable diagnostic tool

According to doctors, in some cases, a thermal imager may be the only method of predicting the development of the disease. So, in order to determine the cause of weakness in a muscle or group of muscles, it is necessary to conduct a number of complex instrumental studies. The doctor must understand what led to this condition — innervation or a violation of blood supply. The device will assess the condition of the blood flow, and the doctor will be able to narrow down the search area. Having excluded the vascular cause, the doctor will focus on innervation and try to be proactive in order to prevent further development of hypotrophy or atrophy.

Photo: IZVESTIA/Sergey Lantyukhov

This method is promising, it has been used by foreign oncologists to monitor patients with breast, skin, and thyroid cancers, and it has shown fairly good results in terms of diagnostic sensitivity, Alexander Malov, a market expert at NTI Helsnet and a therapist at the Center for New Medical Technologies, told Izvestia.

— Dental research was conducted to dynamically monitor patients after tooth extraction to control infectious complications. In vascular surgery, it was used to evaluate the conservative treatment of atherosclerosis, whether blood flow improved or not. In any case, this method will be auxiliary to the gold standard of diagnostics such as blood tests or MRI," the specialist noted.

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This method can also be used in emergency situations, when diagnostic tools are limited, or in remote isolated groups, the specialist said.

Thermal imaging provides a quick, painless "map" of temperature asymmetries on the body surface. She will indicate where there are local hot zones (with inflammation, edema, increased perfusion) or cold ones (possible signs of deterioration of blood supply), said Albert Rizvanov, head of the Personalized Medicine Center of Excellence at the Institute of Fundamental Medicine and Biology of Kazan Federal University.

— The strengths of the method are the primary screening and dynamic monitoring of "yesterday—today" during rehabilitation, in sports medicine and after surgery to monitor the healing and condition of tissues. It also helps the doctor to narrow down the range of possible causes and determine which more complex studies are really needed. The limitations of the technology are comparable to the limitations of a thermometer: one indicator cannot replace a full—fledged diagnosis," the specialist commented.

Photo: IZVESTIA/Polina Violet

The thermal imager sees mainly a surface heat trace and strongly depends on conditions such as indoor temperature, physical exertion, medications, bandages, humidity, smoking, therefore, without a standardized protocol, it is easy to get false alarms or skip a deep process, Albert Rizvanov noted. It does not show the anatomy and does not measure blood flow directly if visualization of veins and assessment of vessels are needed. As a result, the most promising niche of the thermal imager is precisely the role of a "fast tissue thermometer": a safe preliminary step and a monitoring tool that complements, but does not replace, the laboratory and instrumental methods, the expert concluded.

At the moment, an array of information is being accumulated, which will form the basis of software for predicting the rehabilitation of patients with a wide range of pathologies. It is being investigated in the diagnosis of neurological diseases, pain syndromes, and injuries, said Evgeny Achkasov, head of the Department of Sports Medicine and Medical Rehabilitation at Sechenov University.