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

BMJ Open. 2018 Jan 5;8(1):e017964. doi: 10.1136/bmjopen-2017-017964.

Abstract

Objective: To assess the diagnostic accuracy of thermal imaging (TI) in the setting of focal consolidative pneumonia with chest X-ray (CXR) as the gold standard.

Setting: A large, 973-bed teaching hospital in Boston, Massachusetts.

Participants: 47 patients enrolled, 15 in a training set, 32 in a test set. Age range 10 months to 82 years (median=50 years).

Materials and methods: Subjects 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.

Results: With 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%).

Conclusions: This 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.

Keywords: Chest Imaging; Diagnostic Radiology; Paediatric Radiology; Respiratory Infections.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Child
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Hospitals, Teaching*
  • Humans
  • Infant
  • Male
  • Massachusetts
  • Middle Aged
  • Pneumonia / diagnostic imaging*
  • Predictive Value of Tests
  • Proof of Concept Study
  • Radiography, Thoracic*
  • Sensitivity and Specificity
  • Thermography*
  • Urban Population
  • Young Adult