Thermography as a Method for Bedside Monitoring of Infantile Hemangiomas

SIMPLE SUMMARY: Infantile hemangiomas are the most frequent vascular tumors in infants. Conventional diagnosis relies on visual observation of vascular anomalies and ancillary techniques such as Doppler ultrasonography or magnetic resonance. These diagnostic methods are not straightforward and may require trained operators. Children are usually apprehensive of them because they may require the use of gels, general anesthesia, and contact with their skin. As temperature variations induced by a hemangioma can be measured very accurately, we explored thermographic imaging as an alternative tool for clinically monitoring hemangioma extensions before and during treatment. We found a correspondence between the satisfactory evolution of hemangiomas during treatment, their extension, and their temperature. ABSTRACT: Infantile hemangiomas occur in 3 to 10% of infants. To predict the clinical course and counsel on treatment, it is crucial to accurately determine the hemangiomas’ extension, volume, and location. However, this can represent a challenge because hemangiomas may present irregular patterns or be covered by hair, or their depth may be difficult to estimate. Diagnosis is commonly made by clinical inspection and palpation, with physicians basing their diagnoses on visual characteristics such as area, texture, and color. Doppler ultrasonography or magnetic resonance imaging are normally used to estimate depth or to confirm difficult assessments. This paper presents an alternative diagnosis tool—thermography—as a useful, immediate means of carrying out accurate hemangioma examinations. We conducted a study analyzing infantile hemangiomas with a custom thermographic system. In the first phase of the study, 55 hemangiomas of previously diagnosed patients were analyzed with a thermal camera over several sessions. An average temperature variation before and after treatment of −0.19 °C was measured. In the second phase, we selected nine patients and assessed their evolution over nine months by analyzing their thermographic images and implementing dedicated image processing algorithms. In all cases, we found that the thermal image analysis concurred with the independent diagnoses of two dermatologists. We concluded that a higher temperature inside the tumor in the follow-up was indicative of an undesirable evolution.