Similarity of chest X-ray and thermal imaging of focal pneumonia: a randomised proof of concept study at a large urban teaching hospital

• Published in: BMJ open Vol. 8; no. 1; p. e017964
• Main Authors: Wang, Linda T, Cleveland, Robert H, Binder, William, Zwerdling, Robert G, Stamoulis, Caterina, Ptak, Thomas, Sherman, Mindy, Haver, Kenan, Sagar, Pallavi, Hibberd, Patricia
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-01-2018; BMJ Publishing Group
• Subjects: Accuracy; Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Analysis of Variance; Cameras; Child; Child, Preschool; Family medical history; Feasibility Studies; Female; Hospitals, Teaching; Humans; Infant; Male; Massachusetts; Medical diagnosis; Medical imaging; Middle Aged; Patients; Pediatrics; Pneumonia; Pneumonia - diagnostic imaging; Predictive Value of Tests; Proof of Concept Study; Radiography, Thoracic; Radiology and Imaging; Sensitivity and Specificity; Systematic review; Thermography; Thoracic surgery; Tomography; Ultrasonic imaging; Urban Population; X-rays; Young Adult; Cleveland Ohio; United States > US; Massachusetts; Diagnostic Radiology; Respiratory Infections; Chest Imaging; Paediatric Radiology
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-017964

ObjectiveTo assess the diagnostic accuracy of thermal imaging (TI) in the setting of focal consolidative pneumonia with chest X-ray (CXR) as the gold standard.SettingA large, 973-bed teaching hospital in Boston, Massachusetts.Participants47 patients enrolled, 15 in a training set, 32 in a test set. Age range 10 months to 82 years (median=50 years).Materials and methodsSubjects received CXR with subsequent TI within 4 hours of each other. CXR and TI were assessed in blinded random order. Presence of focal opacity (pneumonia) on CXR, the outcome parameter, was recorded. For TI, presence of area(s) of increased heat (pneumonia) was recorded. Fisher’s exact test was used to assess the significance of the correlations of positive findings in the same anatomical region.ResultsWith TI compared with the CXR (the outcome parameter), sensitivity was 80.0% (95% CIs 29.9% to 98.9%), specificity was 57.7% (95% CI 37.2% to 76.0%). Positive predictive value of TI was 26.7% (95% CI 8.9% to55.2%) and its negative predictive value was 93.8% (95% CI 67.7% to 99.7%).ConclusionsThis feasibility study confirms proof of concept that chest TI is consistent with CXR in suggesting similarly localised focal pneumonia with high sensitivity and negative predictive value. Further investigation of TI as a point-of-care imaging modality is warranted.