Breast Thermography as an Adjunct Tool to Monitor the Chemotherapy Response in a Triple Negative BIRADS V Cancer Patient: A Case Study

Prior studies have reported that breast thermography is a potential adjunct tool to mammography in early cancer detection, especially in developing countries with limited medical facilities. This non-invasive, safe, and painless screening tool can reduce the mortality due to cancer by early detection and monitoring. This prospective study aims to analyze changes in static breast thermograms of a BIRADS V category breast cancer patient to assess the response to Neoadjuvant chemotherapy (NACT) in locally advanced cancer and to compare with thermograms of a BIRADS II category benign patient. Breast thermograms of the malignant and benign patients in five different views were taken using FLIR E40 thermal camera under strict acquisition protocols. Details of the patient along with the thermograms were recorded pre and post NACT. There is a qualitative reduction in the warm region of the surface after the first cycle of chemotherapy treatment. Thermal, fractal, and statistical analysis of thermograms is performed for both patients. In the patient with aggressive ductal carcinoma, the difference in the mean surface temperature between contralateral breasts is high, which is reduced after the first cycle of NACT. This preliminary study indicates that breast thermography can potentially be used as an effective non-invasive, non-contact, and radiation-free tool to analyze the effect of NACT on patients with different stages of breast cancer. This study also signifies the role of the thermography technique in reaching a largely rural population with limited medical resources for early cancer screening.

Enhanced Segmentation of Inflamed ROI to Improve the Accuracy of Identifying Benign and Malignant Cases in Breast Thermogram

Effective analysis of breast thermography needs an accurate segmentation of the inflamed region in Infrared Breast Thermal Images (IBTI) which helps in the diagnosis of breast cancer. However, IBTI suffers from intensity inhomogeneity, overlapping regions of interest, poor contrast, and low signal-to-noise ratio (SNR) due to the imperfect image acquisition process. To mitigate this, this work proposes an enhanced segmentation of the inflamed Region of Interest (ROI) using an active contour method driven by the multiscale local and global fitted image (MLGFI) model. The first phase proposes a bilateral histogram difference-based thresholding (BHDT) method for locating the inflamed ROI. This is then used for automatic initialization of active contours driven by MLGFI to segment the inflamed ROI from IBTI effectively. To prove the effectiveness of this segmentation method, its performance is compared with ground truth image and its accuracy is also evaluated with the state-of-the-art methods (Fuzzy C Means (FCM), Chan-Vese (CV-ACM), and K-means). From the analysis, it is found that the proposed method not only increases the precision and the segmentation accuracy but also reduces the oversegmentation and undersegmentation rate significantly. In the second phase, area-based feature (AF) and average intensity-based feature (AIF) along with the GLCM (gray level cooccurrence matrix) based second-order statistical features are extracted from the inflamed ROI. Based on these features, a system is developed to effectively classify the benign and malignant breast conditions. From the results, it is observed that the proposed model exhibits an improved accuracy of 91.5%, sensitivity of 91%, and specificity of 92% compared to the whole breast thermogram. Hence, it is concluded that the proposed method will improve the efficacy of thermal imaging in the diagnosis of breast cancer.

A Computational Method to Assist the Diagnosis of Breast Disease Using Dynamic Thermography

Breast cancer has been the second leading cause of cancer death among women. New techniques to enhance early diagnosis are very important to improve cure rates. This paper proposes and evaluates an image analysis method to automatically detect patients with breast benign and malignant changes (tumors). Such method explores the difference of Dynamic Infrared Thermography (DIT) patterns observed in patients’ skin. After obtaining the sequential DIT images of each patient, their temperature arrays are computed and new images in gray scale are generated. Then the regions of interest (ROIs) of those images are segmented and, from them, arrays of the ROI temperature are computed. Features are extracted from the arrays, such as the ones based on statistical, clustering, histogram comparison, fractal geometry, diversity indices and spatial statistics. Time series that are broken down into subsets of different cardinalities are generated from such features. Automatic feature selection methods are applied and used in the Support Vector Machine (SVM) classifier. In our tests, using a dataset of 68 images, 100% accuracy was achieved.

Thermal Imaging - An Emerging Modality for Breast Cancer Detection: A Comprehensive Review

Breast cancer is not preventable. To reduce the death rate and improve the survival chances of breast cancer patients, early and accurate detection is the only panacea. Delay in diagnosis of this disease causes 60% of deaths. Thermal imaging is a low-risk modality for early breast cancer decision making without injecting any form of energy into the human body. Thermography as a screening tool was first introduced and well accepted in 1956. However, a study in 1977 found that it lagged behind other screening tools and is subjective. Soon after, its use was discontinued. This review discusses various screening tools used to detect breast cancer with a focus on thermography along with their advantages and shortcomings. With the maturation of thermography equipment and technological advances, this technique is emerging and has become the refocus of many biomedical researchers across the globe in the past decade. This study dispenses an exhaustive review of the work done related to interpretation of breast thermal variations and confers the discipline, frameworks, and methodologies used by different authors to diagnose breast cancer. Different performance metrics like accuracy, specificity, and sensitivity have also been examined. This paper outlines the most pressing research gaps for future work to improvise the accuracy of results for diagnosis of breast abnormalities using image processing tools, mathematical modelling and artificial intelligence. However, supplementary research is needed to affirm the potential of this technology for predicting breast cancer risk effectively. Altogether, our findings inform that it is a promising research problem and a potential solution for early detection of breast cancer in younger women.

Role of image thermography in early breast cancer detection- Past, present and future

One of the most prevalent cancers among women is the breast cancer. Accurate diagnosis of breast cancer at an early stage can reduce the mortality associated with this disease. Infrared Breast Thermography, which is a screening tool used to measure the temperature distribution of breast tissue, is a suitable adjunct tool to mammography. Breast thermography has many advantages as it is non-invasive, safe and painless. Thermographic image and usage of artificial neural networks have improved the accuracy of thermography in early diagnosis of breast abnormality. This paper presents survey based on the main steps of computer aided detection systems: image acquisition protocols, segmentation techniques, feature extraction and classification methods, used in the field of breast thermography over the past few decades. The detailed survey emphasizes on the improved reliability of breast thermography .This has become possible with the utilization of machine learning techniques for correct classification of breast thermograms. Numerical Simulation can be used as a supporting method to overcome high false positive rates in thermographic diagnosis. The paper also presents future recommendations to utilize recent machine learning advances in real time.

New formulation of the Gompertz equation to describe the kinetics of untreated tumors

BACKGROUND

Different equations have been used to describe and understand the growth kinetics of undisturbed malignant solid tumors. The aim of this paper is to propose a new formulation of the Gompertz equation in terms of different parameters of a malignant tumor: the intrinsic growth rate, the deceleration factor, the apoptosis rate, the number of cells corresponding to the tumor latency time, and the fractal dimensions of the tumor and its contour.

METHODS

Furthermore, different formulations of the Gompertz equation are used to fit experimental data of the Ehrlich and fibrosarcoma Sa-37 tumors that grow in male BALB/c/Cenp mice. The parameters of each equation are obtained from these fittings.

RESULTS

The new formulation of the Gompertz equation reveals that the initial number of cancerous cells in the conventional Gompertz equation is not a constant but a variable that depends nonlinearly on time and the tumor deceleration factor. In turn, this deceleration factor depends on the apoptosis rate of tumor cells and the fractal dimensions of the tumor and its irregular contour.

CONCLUSIONS

It is concluded that this new formulation has two parameters that are directly estimated from the experiment, describes well the growth kinetics of unperturbed Ehrlich and fibrosarcoma Sa-37 tumors, and confirms the fractal origin of the Gompertz formulation and the fractal property of tumors.

Breast Cancer Identification via Thermography Image Segmentation with a Gradient Vector Flow and a Convolutional Neural Network

Breast cancer is the most common cancer among women worldwide with about half a million cases reported each year. Mammary thermography can offer early diagnosis at low cost if adequate thermographic images of the breasts are taken. The identification of breast cancer in an automated way can accelerate many tasks and applications of pathology. This can help complement diagnosis. The aim of this work is to develop a system that automatically captures thermographic images of breast and classifies them as normal and abnormal (without cancer and with cancer). This paper focuses on a segmentation method based on a combination of the curvature function k and the gradient vector flow, and for classification, we proposed a convolutional neural network (CNN) using the segmented breast. The aim of this paper is to compare CNN results with other classification techniques. Thus, every breast is characterized by its shape, colour, and texture, as well as left or right breast. These data were used for training as well as to compare the performance of CNN with three classification techniques: tree random forest (TRF), multilayer perceptron (MLP), and Bayes network (BN). CNN presents better results than TRF, MLP, and BN.

Fuzzy controller design for breast cancer treatment based on fractal dimension using breast thermograms

In this study, three non-linear indices consist of compression, one-dimensional (1D) and two-dimensional (2D) fractal dimensions are used for the determination of the malignancy or benignity of cancer tumours in breast thermograms. On the other hand, by developing the high-precision infrared cameras as well as new methods of image processing, biomedical thermography images have found a prominent position among the others. Furthermore, cancerous tissue can be affected by the laser. In this study, in order to treat the cancerous lesion identified by breast thermograms, the laser parameters are designed. The basis of controller designing is the obtained non-linear indices. If the indices are moved from the chaotic behaviour to normal condition, the treating tissue is going from cancerous to a healthy condition and the treatment process is completed. Radiation frequency and the energy density of laser are designed as two key elements in the cancer treatment. In this study, the type I and type II fuzzy controllers are employed for the control strategies. Using the proposed closed-loop control, the non-linear indices of the cancerous lesion will be reduced during the treatment process. The simulation results on two datasets of breast thermograms indicate the superiority of type II fuzzy controller.

AUTOMATIC SEGMENTATION OF BREAST TISSUE THERMAL IMAGES

Breast cancer is one of the main causes of women’s death. Thermal breast imaging is one the non-invasive method for cancer at early stage diagnosis. In contrast to mammography this method is cheap and painless and it can be used during pregnancy while ionized beams are not used. Specialists are seeking new ways to diagnose the cancer in early stages. Segmentation of the breast tissue is one of the most indispensable stages in most of the cancer diagnosis methods. By the advancement of infrared precise cameras, new and fast computers and nouvelle image processing approaches, it is feasible to use thermal imaging for diagnosis of breast cancer at early stages. Since the breast form is different in individuals, image segmentation is a hard task and semi-automatic or manual methods are usual in investigations. In this research the image data base of DMR-IR has been utilized and a now automatic approach has been proposed which does not need learning. Data were included 159 gray images used by dynamic protocol (132 healthy and 27 patients). In this study, by combination of different image processing methods, the segmentation of thermal images of the breast tissues have been completed automatically and results show the proper performance of recommended method.

Role of the Interplay Between the Internal and External Conditions in Invasive Behavior of Tumors

Tumor growth, which plays a central role in cancer evolution, depends on both the internal features of the cells, such as their ability for unlimited duplication, and the external conditions, e.g., supply of nutrients, as well as the dynamic interactions between the two. A stem cell theory of cancer has recently been developed that suggests the existence of a subpopulation of self-renewing tumor cells to be responsible for tumorigenesis, and is able to initiate metastatic spreading. The question of abundance of the cancer stem cells (CSCs) and its relation to tumor malignancy has, however, remained an unsolved problem and has been a subject of recent debates. In this paper we propose a novel model beyond the standard stochastic models of tumor development, in order to explore the effect of the density of the CSCs and oxygen on the tumor's invasive behavior. The model identifies natural selection as the underlying process for complex morphology of tumors, which has been observed experimentally, and indicates that their invasive behavior depends on both the number of the CSCs and the oxygen density in the microenvironment. The interplay between the external and internal conditions may pave the way for a new cancer therapy.

Near-Infrared Visual Differentiation in Normal and Abnormal Breast Using Hemoglobin Concentrations

Introduction: Near-infrared (NIR) optical imaging is a non-ionizing modality that is emerging as a diagnostic/prognostic tool for breast cancer according to NIR differentiation of hemoglobin (Hb) concentration. Methods: The transmission values of LED-sourced light at 625 nm were measured by power meter to evaluate the optical properties of Hb in breast phantom containing major and minor vessels. For the simulation of blood variations in cancerous breast condition, we prepared 2 concentrations of pre-menopausal Hb and 4 concentrations of post-menopausal Hb and, for comparison with normal tissue, one concentration of Hb injected inside the phantom's vessels. Imaging procedure on the phantom was also conducted by LED source and CCD camera. The images from the experiments were compared with the results obtained from the images analyzed by MATLAB software. Finally, mammography of phantom including various concentration of Hb was prepared. Results: The transmitting intensities of NIR in blood containing 1, 2 and 4 concentrations of Hb in the major vessels were 52.83±2.85, 43.00±3.11 and 31.17±2.27 µW, respectively, and in minor vessels containing similar Hb concentrations were 73.50±2.43, 60.08±5.09 and 42.42±4.86 µW, respectively. The gray-scale levels on the major vessel were about 96, 124, 162 and on the minor vessel about 72, 100, 130 measured for 1, 2 and 4 Hb concentrations, respectively. The sensitivity and specificity of NIR imaging differentiation were 97.4% and 91.3%, respectively. Conclusion: Significant differences in transmitting intensity, optical imaging as well as software analysis of images were observed for 1, 2 and 4 concentrations of Hb in major and minor breast phantom vessels. Differentiation capability of minor vessels was higher than major vessels for Hb concentrations. Despite a good detection for location of vessels by mammography, it could not show differences between vessels with various concentrations. However, NIR optical imaging demonstrated a good image contrast for showing vessels in terms of concentration. This study recommends NIR optical imaging for prescreening breast cancer due to its potential for early diagnosis.

Computer aided diagnosis of diabetic foot using infrared thermography: A review

Diabetes mellitus (DM) is a chronic metabolic disorder that requires regular medical care to prevent severe complications. The elevated blood glucose level affects the eyes, blood vessels, nerves, heart, and kidneys after the onset. The affected blood vessels (usually due to atherosclerosis) may lead to insufficient blood circulation particularly in the lower extremities and nerve damage (neuropathy), which can result in serious foot complications. Hence, an early detection and treatment can prevent foot complications such as ulcerations and amputations. Clinicians often assess the diabetic foot for sensory deficits with clinical tools, and the resulting foot severity is often manually evaluated. The infrared thermography is a fast, nonintrusive and non-contact method which allows the visualization of foot plantar temperature distribution. Several studies have proposed infrared thermography-based computer aided diagnosis (CAD) methods for diabetic foot. Among them, the asymmetric temperature analysis method is more superior, as it is easy to implement, and yielded satisfactory results in most of the studies. In this paper, the diabetic foot, its pathophysiology, conventional assessments methods, infrared thermography and the different infrared thermography-based CAD analysis methods are reviewed.

Extraction of medically interpretable features for classification of malignancy in breast thermography

Thermography, with high-resolution cameras, is being re-investigated as a possible breast cancer screening imaging modality, as it does not have the harmful radiation effects of mammography. This paper focuses on automatic extraction of medically interpretable non-vascular thermal features. We design these features to differentiate malignancy from different non-malignancy conditions, including hormone sensitive tissues and certain benign conditions, which have an increased thermal response. These features increase the specificity for breast cancer screening, which had been a long known problem in thermographic screening, while retaining high sensitivity. These features are also agnostic to different cameras and resolutions (up to an extent). On a dataset of around 78 subjects with cancer and 187 subjects without cancer, that have some benign diseases and conditions with thermal responses, we are able to get around 99% specificity while having 100% sensitivity. This indicates a potential break-through in thermographic screening for breast cancer. This shows promise for undertaking a comparison to mammography with larger numbers of subjects with more data variations.

Application of infrared thermography in computer aided diagnosis

The invention of thermography, in the 1950s, posed a formidable problem to the research community: What is the relationship between disease and heat radiation captured with Infrared (IR) cameras? The research community responded with a continuous effort to find this crucial relationship. This effort was aided by advances in processing techniques, improved sensitivity and spatial resolution of thermal sensors. However, despite this progress fundamental issues with this imaging modality still remain. The main problem is that the link between disease and heat radiation is complex and in many cases even non-linear. Furthermore, the change in heat radiation as well as the change in radiation pattern, which indicate disease, is minute. On a technical level, this poses high requirements on image capturing and processing. On a more abstract level, these problems lead to inter-observer variability and on an even more abstract level they lead to a lack of trust in this imaging modality. In this review, we adopt the position that these problems can only be solved through a strict application of scientific principles and objective performance assessment. Computing machinery is inherently objective; this helps us to apply scientific principles in a transparent way and to assess the performance results. As a consequence, we aim to promote thermography based Computer-Aided Diagnosis (CAD) systems. Another benefit of CAD systems comes from the fact that the diagnostic accuracy is linked to the capability of the computing machinery and, in general, computers become ever more potent. We predict that a pervasive application of computers and networking technology in medicine will help us to overcome the shortcomings of any single imaging modality and this will pave the way for integrated health care systems which maximize the quality of patient care.

Analysis of breast thermograms using Gabor wavelet anisotropy index

In this study, an attempt is made to distinguish the normal and abnormal tissues in breast thermal images using Gabor wavelet transform. Thermograms having normal, benign and malignant tissues are considered in this study and are obtained from public online database. Segmentation of breast tissues is performed by multiplying raw image and ground truth mask. Left and right breast regions are separated after removing the non-breast regions from the segmented image. Based on the pathological conditions, the separated breast regions are grouped as normal and abnormal tissues. Gabor features such as energy and amplitude in different scales and orientations are extracted. Anisotropy and orientation measures are calculated from the extracted features and analyzed. A distinctive variation is observed among different orientations of the extracted features. It is found that the anisotropy measure is capable of differentiating the structural changes due to varied metabolic conditions. Further, the Gabor features also showed relative variations among different pathological conditions. It appears that these features can be used efficiently to identify normal and abnormal tissues and hence, improve the relevance of breast thermography in early detection of breast cancer and content based image retrieval.

Evaluation of the diagnostic power of thermography in breast cancer using Bayesian network classifiers

Breast cancer is one of the leading causes of death among women worldwide. There are a number of techniques used for diagnosing this disease: mammography, ultrasound, and biopsy, among others. Each of these has well-known advantages and disadvantages. A relatively new method, based on the temperature a tumor may produce, has recently been explored: thermography. In this paper, we will evaluate the diagnostic power of thermography in breast cancer using Bayesian network classifiers. We will show how the information provided by the thermal image can be used in order to characterize patients suspected of having cancer. Our main contribution is the proposal of a score, based on the aforementioned information, that could help distinguish sick patients from healthy ones. Our main results suggest the potential of this technique in such a goal but also show its main limitations that have to be overcome to consider it as an effective diagnosis complementary tool.

BREAST THERMOGRAPHY AS A POTENTIAL NON-CONTACT METHOD IN THE EARLY DETECTION OF CANCER: A REVIEW

This review paper discusses recent research achievements in medical thermography with concerns about the possibility of early breast cancer detection. With the advancements in infrared (IR) technology, image processing methods, and the pathophysiological-based knowledge of thermograms, IR screening is sufficiently mature to be utilized as a first-line complement to both health managing and clinical prognosis. In addition, it explains the performance and environmental conditions in identifying thermography for breast tumor imaging under strict indoor controlled environmental circumstances. An irregular thermogram is indicated as a significant biological risk marker for the presence or growth of breast tumors. Breast thermography is completely non-contact, with no form of radiation and compression. It is useful for all women of all ages, for pregnant and breastfeeding women, for women with implants, for women with dense or fibrocystic breasts, for women on hormone replacement therapy, and for pre or post menopausal women.

Breast thermography is specifically worthwhile during the early stages of fast tumor growth, which is not yet recognizable by mammography as thermography is a physiological test while mammography is an anatomical one. Often, physiological changes precede anatomical changes. This early detection of irregular tissue liveliness gives breast thermography the potential to be greatly useful and economical as an imaging program and provides the opportunity to apply non-invasive treatment to reform breast tissue activity. The non-radiating nature of thermography also permits repeated images. Thus, changes can be compared over time and the results of protective approaches can be observed to ensure utmost care of breast cells.

Automated detection of optic disk in retinal fundus images using intuitionistic fuzzy histon segmentation

The human eye is one of the most sophisticated organs, with perfectly interrelated retina, pupil, iris cornea, lens, and optic nerve. Automatic retinal image analysis is emerging as an important screening tool for early detection of eye diseases. Uncontrolled diabetic retinopathy (DR) and glaucoma may lead to blindness. The identification of retinal anatomical regions is a prerequisite for the computer-aided diagnosis of several retinal diseases. The manual examination of optic disk (OD) is a standard procedure used for detecting different stages of DR and glaucoma. In this article, a novel automated, reliable, and efficient OD localization and segmentation method using digital fundus images is proposed. General-purpose edge detection algorithms often fail to segment the OD due to fuzzy boundaries, inconsistent image contrast, or missing edge features. This article proposes a novel and probably the first method using the Attanassov intuitionistic fuzzy histon (A-IFSH)–based segmentation to detect OD in retinal fundus images. OD pixel intensity and column-wise neighborhood operation are employed to locate and isolate the OD. The method has been evaluated on 100 images comprising 30 normal, 39 glaucomatous, and 31 DR images. Our proposed method has yielded precision of 0.93, recall of 0.91, F-score of 0.92, and mean segmentation accuracy of 93.4%. We have also compared the performance of our proposed method with the Otsu and gradient vector flow (GVF) snake methods. Overall, our result shows the superiority of proposed fuzzy segmentation technique over other two segmentation methods.