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. 2021 May 25;10(11):2301.
doi: 10.3390/jcm10112301.

Infrared Thermal Imaging as a Novel Non-Invasive Point-of-Care Tool to Assess Filarial Lymphoedema

Louise A Kelly-Hope  1 , Mohammad Jahirul Karim  2 , Asm Sultan Mahmood  2 , Abdullah Al Kawsar  2 , Abul Khair  2 , Hannah Betts  1 , Janet Douglass  1 , Armelle Forrer  1 , Mark J Taylor  1
Affiliations

Infrared Thermal Imaging as a Novel Non-Invasive Point-of-Care Tool to Assess Filarial Lymphoedema

Louise A Kelly-Hope et al. J Clin Med. .

Abstract

Lymphatic filariasis causes disfiguring and disabling lymphoedema, which is commonly and frequently exacerbated by acute dermatolymphangioadenitis (ADLA). Affected people require long-term care and monitoring but health workers lack objective assessment tools. We examine the use of an infrared thermal imaging camera as a novel non-invasive point-of-care tool for filarial lower-limb lymphoedema in 153 affected adults from a highly endemic area of Bangladesh. Temperature differences by lymphoedema stage (mild, moderate, severe) and ADLA history were visualised and quantified using descriptive statistics and regression models. Temperatures were found to increase by severity and captured subclinical differences between no lymphoedema and mild lymphoedema, and differences between moderate and severe stages. Toes and ankle temperatures detected significant differences between all stages other than between mild and moderate stages. Significantly higher temperatures, best captured by heel and calf measures, were found in participants with a history of ADLA, compared to participants who never had ADLA, regardless of the lymphoedema stage. This novel tool has great potential to be used by health workers to detect subclinical cases, predict progression of disease and ADLA status, and monitor pathological tissue changes and stage severity following enhanced care packages or other interventions in people affected by lymphoedema.

Keywords: NTDs; infrared thermal imaging; lymphatic filariasis; lymphoedema; neglected tropical diseases; point of care; skin temperature; tissue tonometry.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Location of temperature regions of interest (ROI) on front and back of legs. In total eight ROI on each leg were selected and included (A) the anterior leg at shin, ankle and toes on the whole-leg at 1m distance; (B) close-up of ankle and toes at 0.5 m distance; (C) the posterior leg at the back of the knee, calf and heel on the whole-leg at 1m distance.
Figure 2
Figure 2
Cases studies–images and temperature measurements from four participants (A–D) with lymphoedema. Each participant had three images taken including the whole lower-leg (front and back), and a close-up image of the ankle and toes.
Figure 3
Figure 3
Comparison of temperature differences at regions of interest (ROIs) by lymphoedema stage. First section: No lymphoedema (Stage 0) compared to mild, moderate, severe (Stages 1–3); second section: mild (Stage 1) compared to moderate and severe lymphoedema (Stages 2 and 3), and third section: moderate (Stage 2) compared to severe lymphoedema (Stage 3). The red dashed line indicates a coefficient value of zero. Therefore, a coefficient which confidence interval (CI) crosses the dash/zero line is not significant at 95% level.
Figure 4
Figure 4
Comparison of temperatures at regions of interest (ROIs) by history of ADLA and lymphoedema stage.
See this image and copyright information in PMC

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