{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:06:44Z","timestamp":1791824804563,"version":"4.3.4"},"reference-count":33,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Infrared thermography (IRT) is an imaging technique used in clinical practice to detect changes in skin temperature caused by several dysfunctions, including breast cancer-related lymphedema (BCRL). Thus, the present study aimed to assess the reproducibility and accuracy of IRT in diagnosing BCRL. Methods: This cross-sectional study included participants who underwent a unilateral mastectomy and used indirect volumetry for lymphedema detection. IRT analysis was recorded in four positions, analyzing maximum, mean, and minimum temperatures, as well as the temperature differences between the upper limbs. The analysis encompassed reliability, agreement, accuracy, and the establishment of cut-off points for sensitivity and specificity. A total of 88 upper limbs were included; 176 thermograms were captured, and 1056 regions of interest were analyzed. Results: IRT presented excellent intra- and inter-rater reproducibility and reliability with excellent intraclass correlation coefficient values (0.99 to 1.00). In addition, this assessment reached a sensitivity of 85% and a specificity of 56%; the cut-off point considered a temperature difference of \u22120.45 \u00b0C. Conclusions: IRT was a reliable and reproducible assessment, and the temperature difference between the upper limbs evidenced moderate accuracy. Thus, IRT is recommended as a complementary technique for detecting BCRL.<\/jats:p>","DOI":"10.3390\/jcm13206054","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T03:53:47Z","timestamp":1728618827000},"page":"6054","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Accuracy of Infrared Thermography in Diagnosing Breast Cancer-Related Lymphedema"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6866-6808","authenticated-orcid":false,"given":"Vanessa Maria da Silva Alves","family":"Gomes","sequence":"first","affiliation":[{"name":"Departamento de Fisioterapia, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal de Pernambuco, Av. Jornalista An\u00edbal Fernandes, 173, Cidade Universit\u00e1ria, Sala 2, 1\u00ba andar, Recife 50740-560, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4822-8314","authenticated-orcid":false,"given":"Marcos Leal","family":"Brioschi","sequence":"additional","affiliation":[{"name":"Medical Thermology and Thermography Specialization, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-010, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Rafaela Cardozo da","family":"Silva","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal de Pernambuco, Av. Jornalista An\u00edbal Fernandes, 173, Cidade Universit\u00e1ria, Sala 2, 1\u00ba andar, Recife 50740-560, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naiany","family":"Ten\u00f3rio","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal de Pernambuco, Av. Jornalista An\u00edbal Fernandes, 173, Cidade Universit\u00e1ria, Sala 2, 1\u00ba andar, Recife 50740-560, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Raynelle Patriota","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal de Pernambuco, Av. Jornalista An\u00edbal Fernandes, 173, Cidade Universit\u00e1ria, Sala 2, 1\u00ba andar, Recife 50740-560, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cla\u00fadia Souza da","family":"Silva","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal de Pernambuco, Av. Jornalista An\u00edbal Fernandes, 173, Cidade Universit\u00e1ria, Sala 2, 1\u00ba andar, Recife 50740-560, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Netto","family":"Maia","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal de Pernambuco, Av. Jornalista An\u00edbal Fernandes, 173, Cidade Universit\u00e1ria, Sala 2, 1\u00ba andar, Recife 50740-560, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1966-3352","authenticated-orcid":false,"given":"Diego","family":"Dantas","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal de Pernambuco, Av. Jornalista An\u00edbal Fernandes, 173, Cidade Universit\u00e1ria, Sala 2, 1\u00ba andar, Recife 50740-560, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Keszty\u00fcs, D., Brucher, S., Wilson, C., and Keszty\u00fcs, T. (2023). Use of Infrared Thermography in Medical Diagnosis, Screening, and Disease Monitoring: A Scoping Review. Medicina, 59.","DOI":"10.3390\/medicina59122139"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Brix, B., Sery, O., Onorato, A., Ure, C., Roessler, A., and Goswami, N. (2021). Biology of Lymphedema. Biology, 10.","DOI":"10.3390\/biology10040261"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1016\/j.bjps.2020.05.039","article-title":"Correlation between Indocyanine Green Lymphography and Thermography to Evaluate Areas of Dermal Backflow in Lymphedema","volume":"73","year":"2020","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kelly-Hope, L.A., Karim, M.J., Sultan Mahmood, A., Al Kawsar, A., Khair, A., Betts, H., Douglass, J., Forrer, A., and Taylor, M.J. (2021). Infrared Thermal Imaging as a Novel Non-Invasive Point-of-Care Tool to Assess Filarial Lymphoedema. J. Clin. Med., 10.","DOI":"10.3390\/jcm10112301"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1245\/s10434-020-09346-0","article-title":"Patient-Reported Outcome Measures in Lymphedema: A Systematic Review and COSMIN Analysis","volume":"28","author":"Beelen","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"179","DOI":"10.5606\/tftrd.2018.3539","article-title":"Lymphedema Diagnosis, Treatment, and Follow-up from the View Point of Physical Medicine and Rehabilitation Specialists","volume":"64","author":"Borman","year":"2018","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-023-06947-7","article-title":"Advances in the Prevention and Treatment of Breast Cancer-Related Lymphedema","volume":"200","author":"Donahue","year":"2023","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_8","first-page":"28","article-title":"Understanding Normal Seasonal Variations in Upper-Limb Size, Volume and Fluid Distribution in a Healthy Female Population: A North Queensland Study","volume":"12","author":"Matthews","year":"2021","journal-title":"Wounds Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s00520-019-05101-8","article-title":"What Are the Economic Burden and Costs Associated with the Treatment of Breast Cancer-Related Lymphoedema? A Systematic Review","volume":"28","author":"Nevelsteen","year":"2020","journal-title":"Support. Care Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1089\/lrb.2019.0002","article-title":"Using Thermography in the Diagnostics of Lymphedema: Pilot Study","volume":"18","author":"Skrzek","year":"2020","journal-title":"Lymphat. Res. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1093\/ptj\/pzx050","article-title":"Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association","volume":"97","author":"Levenhagen","year":"2017","journal-title":"Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1089\/lrb.2017.0081","article-title":"Agreement between Optoelectronic Volumetry and Circumferential Girth Measurements to Diagnose Lymphedema in Patients Submitted to Axillary Radical Lymphadenectomy for Treatment of Cutaneous Melanoma","volume":"19","author":"Campanholi","year":"2021","journal-title":"Lymphat. Res. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"26","DOI":"10.18073\/2358-4696\/pajmt.v2n1p26-34","article-title":"American Academy of Thermology Guidelines for Breast Thermography","volume":"2","author":"Schwartz","year":"2015","journal-title":"Pan Am. J. Med. Thermol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s10916-017-0730-7","article-title":"Accuracy and Reliability of Infrared Thermography in Assessment of the Breasts of Women Affected by Cancer","volume":"41","author":"Carrara","year":"2017","journal-title":"J. Med. Syst."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Brioschi, M.L., Dalmaso Neto, C., Toledo, M.d., Neves, E.B., Vargas, J.V.C., and Teixeira, M.J. (2023). Infrared Image Method for Possible COVID-19 Detection through Febrile and Subfebrile People Screening. J. Therm. Biol., 112.","DOI":"10.1016\/j.jtherbio.2022.103444"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_17","first-page":"125","article-title":"The Glamorgan Protocol for Recording and Evaluation of Thermal Images of the Human Body","volume":"18","author":"Ammer","year":"2008","journal-title":"Thermol. Int."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ribeiro, D.C., Belgrave, A., Naden, A., Fang, H., Matthews, P., and Parshottam, S. (2018). The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature. BMC Musculoskelet. Disord., 19.","DOI":"10.1186\/s12891-018-2157-9"},{"key":"ref_19","first-page":"YE01","article-title":"Requirements for Minimum Sample Size for Sensitivity and Specificity Analysis","volume":"10","author":"Bujang","year":"2016","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.apmr.2018.08.185","article-title":"Intra- and Interrater Reliability and Concurrent Validity of a New Tool for Assessment of Breast Cancer\u2013Related Lymphedema of the Upper Extremity","volume":"100","author":"Spinelli","year":"2019","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_21","unstructured":"LUCAS, R., and Brioschi, M.L. (2016). Termografia Aplicada \u00e0 Fisioterapia, Sistema Wallace Consultoria Ltda. [1st ed.]."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.infrared.2018.06.017","article-title":"Is the Maximum Value in the Region of Interest a Reliable Indicator of Skin Temperature?","volume":"94","author":"Formenti","year":"2018","journal-title":"Infrared Phys. Technol."},{"key":"ref_23","first-page":"831369","article-title":"Thermographic Patterns of the Upper and Lower Limbs: Baseline Data","volume":"2015","author":"Gatt","year":"2015","journal-title":"Int. J. Vasc. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jtherbio.2019.04.008","article-title":"Biomedical Musculoskeletal Applications of Infrared Thermal Imaging on Arm and Forearm: A Systematic Review","volume":"82","author":"Vardasca","year":"2019","journal-title":"J. Therm. Biol."},{"key":"ref_25","unstructured":"Mabuchi, K.S. (1995). Thermography in Lymphedema. International Advance Techniques and Clinical Applications in Biomedical Thermology, Harwood Academic Publishers."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Azhar, S.H., Lim, H.Y., Tan, B.-K., and Angeli, V. (2020). The Unresolved Pathophysiology of Lymphedema. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.00137"},{"key":"ref_27","unstructured":"Osilla, E.V., Marsidi, J.L., Shumway, K.R., and Sharma, S. (2023). Physiology, Temperature Regulation. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1152\/japplphysiol.00921.2010","article-title":"Mechanisms and Modulators of Temperature Regulation","volume":"109","author":"Crandall","year":"2010","journal-title":"J. Appl. Physiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e1396","DOI":"10.1097\/GOX.0000000000001396","article-title":"Diagnostic Accuracy of Lymphoscintigraphy for Lymphedema and Analysis of False-Negative Tests","volume":"5","author":"Hassanein","year":"2017","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"725","DOI":"10.2147\/CCID.S354320","article-title":"Potential Use of Novel Image and Signal Processing Methods to Develop a Quantitative Assessment of the Severity of Acute Radiation Dermatitis in Breast Cancer Radiotherapy","volume":"15","author":"Michalecki","year":"2022","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"117","DOI":"10.5582\/ddt.2016.01033","article-title":"Low-Temperature Infiltration Identified Using Infrared Thermography in Patients with Subcutaneous Edema Revealed Ultrasonographically: A Case Report","volume":"10","author":"Oya","year":"2016","journal-title":"Drug Discov. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s10549-022-06667-4","article-title":"Prediction of Breast Cancer-Related Lymphedema by Dermal Backflow Detected with near-Infrared Fluorescence Lymphatic Imaging","volume":"195","author":"Aldrich","year":"2022","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_33","unstructured":"Kakileti, S.T., Manjunath, G., Schwartz, R.G., and Frangi, A.F. (2023, January 2). The Socioeconomic Impact of Artificial Intelligence Applications in Diagnostic Medical Thermography: A Comparative Analysis with Mammography in Breast Cancer Detection and Other Diseases Early Detection. Proceedings of the Artificial Intelligence over Infrared Images for Medical Applications, Vancouver, BC, Canada."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/20\/6054\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:11:05Z","timestamp":1760112665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/20\/6054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,11]]},"references-count":33,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["jcm13206054"],"URL":"https:\/\/doi.org\/10.3390\/jcm13206054","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,11]]}}}