Thermography Shows Promise for Monitoring Infantile Hemangioma

By Reuters Staff

June 26, 2014

NEW YORK (Reuters Health) - Infrared thermography (IRT) is a reliable, effective strategy for assessing and monitoring the growth of infantile hemangiomas, according to new findings.

Nearly one in 10 children has an infantile hemangioma (IH), the most common benign tumor of infancy, Dr. Javed Ayoub Mohammed of the University of Western Ontario in London and colleagues note in their report. IHs can range from small, superficial growths to disfiguring, large tumors that can affect organ function.

IHs typically proliferate and involute over time, the investigators add, and knowledge of an IH's place on this "proliferation-involution curve" is important for both recommending treatment and evaluating treatment effectiveness.

Yet, "Despite its importance, routine assessment of IHs has largely remained unchanged for decades, often relying solely on the physician's subjective assessment of color, size, tenseness, and temperature," Dr. Mohammed and his team write.

Given that clinicians and parents report that surface temperature of an IH increases during growth and normalizes during involution, the researchers sought to investigate whether IRT might be useful for assessing the growths. They enrolled a convenience sample of 42 infants up to six months of age with an IH. Children were followed for at least three clinical visits, at least one month apart. Thirty-six of them were receiving treatment during the study.

At baseline the mean temperature difference between the IH and the skin on the contralateral unaffected side was 1.9 degrees Fahrenheit, which peaked at 2.5 degrees F at three months and then decreased over time to 0.2 degrees F at 18.5 months. There was an inverse correlation between temperature difference and mean visual analog scale score (r=-0.25).

Facial location, age, and baseline surface area were each independently linked to temperature difference over time, while IH type and treatment were the only factors that affected time to reach zero-temperature difference, according to findings published online June 18 in JAMA Dermatology.

At 18 months, 32 of the 36 treated IHs had reached a zero-temperature difference, versus three of the six untreated IHs. All of the 38 parents who completed a questionnaire about the IRT method said it was easy to implement, and none said it was inconvenient.

"The present study demonstrates that IRT is a reliable and valid measure of IH growth that is well adapted to the clinical setting," Dr. Mohammed and his colleagues write. "It has the potential to provide the clinician with real-time results from which management decisions can be made and treatment efficacy evaluated. Future studies are required to evaluate IRT in relation to other objective measures of IH growth, as well as to assess its applicability in complicated IHs."

Dr. Mohammed did not respond to a request for comment by press time.

SOURCE: http://bit.ly/1qJpBfw

JAMA Dermatol 2014.

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