S3290 Thermographic Endoscopy for Dynamic Thermal Analysis of Gastrointestinal Disease

Abstract

Introduction: To date the temperature has not been recognized an important factor in endoscopic fields, though it is physical finding to evaluate the disease. The medical common sense about thermic homeostasis interrupted notifying the availability of temperature measurement for digestive inflammation. Recently the real time monitoring by thermography in esophagus has been reported to prevent patients from burning during the cardiac ablation therapy to treat atrial fibrillation. The thermography has been used for evaluating the Raynaud' s symptom too. The portable thermography has been introduced into military uses or detection of COVID-19 patients in these days. Methods: 1) Thermographic images were obtained by a thermographic unit attached to a conventional colonoscope. It was inserted over the scope style. The protocol was approved by IRB in my hospital. 2) The prototype thermographic unit was composed of 3 parts (optical lens, image sensor (Seek Thermal or FLIR;USA), microprocessor and USB). 3) In the pilot study, the control group consisted of 4 subjects without inflammation and disease group consisted of 4 patients (2 with ulcerative colitis and 2 with polyp or early cancer) were examined. 4) Transient thermal response (TTR) was evaluated by measuring mucosal temperature changes just before and after spraying cool water. Results: 1) The temperature resolution of thermographic endoscope was 0.1 °C and the accuracy was 0.5°C. The measuring time was 0.4 second enough short to evaluate TTR. 2)The colonic temperatures in the control group were as stable as data measured by thermistor thermometer through the forceps channel (DDW2021). On the contrary, that in UC was 0.5∼1.0°C higher in the area with inflammation than in normal mucosa. 3) The increases of the mucosal temperature in UC patients were correlated to Mayor's endoscopic sub-score. 4) On the TTR, temperature recovery after spraying cool water was significantly delayed parts with inflammation in a UC patient compared to that of control group. 6) The hypervascular mucosa in tumor had shorter recovery time than normal mucosa on the TTR analysis. This mechanism enabled the thermographic endoscope to discriminate the lesion. Conclusion: The temperature and image resolution of thermography should be improved in future, thogh they are not adquate compared to the present conventional endoscope. The thermographic endoscope equipped the TTR function has the possibility to clarify the grade of inflammation and to figure out the tumor..