{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:39:04Z","timestamp":1792186744542,"version":"4.4.0"},"reference-count":47,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Medical infrared thermography, which involves the use of infrared thermal cameras for the non-invasive assessment of skin surface temperature distribution, has gained increasing interest in recent years as a tool supporting diagnosis and treatment monitoring. The aim of this article is to present the historical background and critically reassess the current role of infrared thermography in medicine, with particular emphasis on standardization as a key determinant of its clinical utility. This Perspective highlights the fundamental impact of methodological variability on diagnostic performance and reproducibility. A structured framework for standardization is proposed, encompassing patient preparation, environmental conditions, device parameters and calibration, image acquisition protocols, region-of-interest definition and analysis, as well as reporting and clinical interpretation. The analysis demonstrates how inconsistencies at each of these levels reduce measurement reliability, limit inter-study comparability, and weaken clinical confidence in infrared thermography. The article also addresses the growing availability of mobile thermal imaging systems and their integration with artificial intelligence, while emphasizing the need for stronger evidence-based support across all methodological domains. The presented analysis suggests that, despite existing limitations, medical infrared thermography holds considerable potential as a supportive clinical tool. However, its broader clinical implementation remains limited by several factors, with the lack of standardized protocols constituting a major and practically addressable translational barrier. Wider adoption will require standardization efforts alongside rigorous validation studies and application-specific interpretative guidelines. Addressing these challenges through technological advances and coordinated international standardization may facilitate meaningful progress over the next decade.<\/jats:p>","DOI":"10.3390\/medicina62061204","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:49:55Z","timestamp":1782121795000},"page":"1204","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Use of Infrared Thermography: Where Are We and Where Are We Going"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2427-9179","authenticated-orcid":false,"given":"Agnieszka","family":"Wnuk-Scardaccione","sequence":"first","affiliation":[{"name":"Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawi\u0144ska Street, 31-066 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2699-3798","authenticated-orcid":false,"given":"Jan","family":"Bilski","sequence":"additional","affiliation":[{"name":"Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawi\u0144ska Street, 31-066 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.cbpa.2016.02.022","article-title":"Infrared thermography: A non-invasive window into thermal physiology","volume":"202","author":"Tattersall","year":"2016","journal-title":"Comp. Biochem. Physiol. Part A Mol. Integr. Physiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.infrared.2012.03.007","article-title":"Medical applications of infrared thermography: A review","volume":"55","author":"Lahiri","year":"2012","journal-title":"Infrared Phys. Technol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/milmed\/167.5.384","article-title":"Foot evaluation by infrared imaging","volume":"167","author":"DiBenedetto","year":"2002","journal-title":"Mil. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2217\/bmt.13.4","article-title":"Thermography in breast cancer diagnosis, screening and risk assessment: Systematic review","volume":"2","author":"Houssami","year":"2013","journal-title":"Breast Cancer Manag."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"R33","DOI":"10.1088\/0967-3334\/33\/3\/R33","article-title":"Infrared thermal imaging in medicine","volume":"33","author":"Ring","year":"2012","journal-title":"Physiol. Meas."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jtherbio.2008.11.008","article-title":"Visualization of body thermoregulation by infrared imaging","volume":"34","author":"Bouzida","year":"2009","journal-title":"J. Therm. Biol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Piva, G., Crepaldi, A., Zenunaj, G., Caruso, L., Rinaldo, N., Gasbarro, V., Lamberti, N., L\u00f3pez-Soto, P.J., and Manfredini, F. (2022). The value of infrared thermography to assess foot and limb perfusion in relation to medical, surgical, exercise or pharmacological interventions in peripheral artery disease: A systematic review. Diagnostics, 12.","DOI":"10.3390\/diagnostics12123007"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1016\/j.jvs.2011.03.287","article-title":"The application of infrared thermography in evaluation of patients at high risk for lower extremity peripheral arterial disease","volume":"54","author":"Huang","year":"2011","journal-title":"J. Vasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e70071","DOI":"10.1002\/dev.70071","article-title":"Infrared thermal imaging (ITI), a non-invasive window into early emotion regulation: A systematic review","volume":"67","author":"Nazzari","year":"2025","journal-title":"Dev. Psychobiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1080\/23328940.2017.1397085","article-title":"The use of infrared thermography in the measurement and characterization of brown adipose tissue activation","volume":"5","author":"Law","year":"2018","journal-title":"Temperature"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Gioia, F., Nardelli, M., Scilingo, E.P., and Greco, A. (2023). Autonomic regulation of facial temperature during stress: A cross-mapping analysis. Sensors, 23.","DOI":"10.3390\/s23146403"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1177\/193229681000400613","article-title":"Correlation between plantar foot temperature and diabetic neuropathy: A case study by using an infrared thermal imaging technique","volume":"4","author":"Bagavathiappan","year":"2010","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1088\/1361-6579\/aa6ea0","article-title":"Enhanced thermal imaging of wound tissue for better clinical decision making","volume":"38","author":"Keenan","year":"2017","journal-title":"Physiol. Meas."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jtherbio.2014.10.006","article-title":"Considerations for the measurement of core, skin and mean body temperatures","volume":"46","author":"Taylor","year":"2014","journal-title":"J. Therm. Biol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.jtherbio.2010.08.001","article-title":"Temperature changes of selected body\u2019s surfaces of handball players in the course of training estimated by thermovision, and the study of the impact of physiological and morphological factors on the skin temperature","volume":"35","author":"Chudecka","year":"2010","journal-title":"J. Therm. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jtherbio.2006.03.003","article-title":"Predicting the effect of relative humidity on skin temperature and skin wettedness","volume":"31","author":"Atmaca","year":"2006","journal-title":"J. Therm. Biol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lubkowska, A., and Pluta, W. (2022). Infrared thermography as a non-invasive tool in musculoskeletal disease rehabilitation\u2014The control variables in applicability\u2014A systematic review. Appl. Sci., 12.","DOI":"10.3390\/app12094302"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sonenblum, S.E., Jordan, K., John, G.T., Chung, A., Asare-Baiden, M., Pelkmans, J., Gichoya, J.W., Hertzberg, V.S., and Ho, J.C. (2025). Impact of skin tone, environmental, and technical factors on thermal imaging. PLoS ONE, 20.","DOI":"10.1101\/2025.05.08.25327244"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"103826","DOI":"10.1016\/j.jtherbio.2024.103826","article-title":"Confounding factors in peripheral thermal recovery time after active cooling","volume":"121","author":"Pakarinen","year":"2024","journal-title":"J. Therm. Biol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Wang, Q., Zhou, Y., Ghassemi, P., McBride, D., Casamento, J.P., and Pfefer, T.J. (2022). Infrared thermography for measuring elevated body temperature: Clinical accuracy, calibration, and evaluation. Sensors, 22.","DOI":"10.3390\/s22010215"},{"key":"ref_21","first-page":"7","article-title":"Quality assurance for a multi-centre thermography study","volume":"28","author":"Marjanovic","year":"2018","journal-title":"Thermol. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2707","DOI":"10.1007\/s11517-025-03348-4","article-title":"Assessing detector stability and image quality of thermal cameras on smartphones for medical applications: A comparative study","volume":"63","author":"Bernard","year":"2025","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1186\/s13643-024-02708-9","article-title":"Breast thermography: A systematic review and meta-analysis","volume":"13","year":"2024","journal-title":"Syst. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"003","DOI":"10.18073\/pajmt.2021.8.003","article-title":"The American Academy of Thermology Guidelines for Breast Thermology 2021","volume":"8","author":"Schwartz","year":"2021","journal-title":"Pan Am. J. Med. Thermol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e70741","DOI":"10.1111\/iwj.70741","article-title":"A comprehensive scoping review on the use of point-of-care infrared thermography devices for assessing various wound types","volume":"22","author":"Rahman","year":"2025","journal-title":"Int. Wound J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e12167","DOI":"10.14814\/phy2.12167","article-title":"Infrared thermography in the detection of brown adipose tissue in humans","volume":"2","author":"Jang","year":"2014","journal-title":"Physiol. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cao, Z., Zeng, Z., Xie, J., Zhai, H., Yin, Y., Ma, Y., and Tian, Y. (2023). Diabetic plantar foot segmentation in active thermography using a two-stage adaptive gamma transform and a deep neural network. Sensors, 23.","DOI":"10.3390\/s23208511"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.jtv.2024.06.018","article-title":"Can thermography predict diabetic foot ulcer risk in patients with diabetes mellitus? A systematic review","volume":"33","author":"Murray","year":"2024","journal-title":"J. Tissue Viability"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1111\/iwj.12811","article-title":"An explorative study on the validity of various definitions of a 2.2 \u00b0C temperature threshold as warning signal for impending diabetic foot ulceration","volume":"14","author":"Wijlens","year":"2017","journal-title":"Int. Wound J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1177\/19322968241249970","article-title":"Infrared thermography shows that a temperature difference of 2.2 \u00b0C (4 \u00b0F) or greater between corresponding sites of neuropathic feet does not always lead to a diabetic foot ulcer","volume":"19","author":"Liew","year":"2025","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ptsp.2022.10.005","article-title":"Accuracy of infrared thermography in detecting tendinopathy: A systematic review with meta-analysis","volume":"58","author":"Kamonseki","year":"2022","journal-title":"Phys. Ther. Sport"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e23529","DOI":"10.1097\/MD.0000000000023529","article-title":"Infrared thermography in the diagnosis of musculoskeletal injuries: A protocol for a systematic review and meta-analysis","volume":"99","author":"Li","year":"2020","journal-title":"Medicine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"103444","DOI":"10.1016\/j.jtherbio.2022.103444","article-title":"Infrared image method for possible COVID-19 detection through febrile and subfebrile people screening","volume":"112","author":"Brioschi","year":"2023","journal-title":"J. Therm. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1515\/dx-2021-0091","article-title":"Is body temperature mass screening a reliable and safe option for preventing COVID-19 spread?","volume":"9","author":"Lippi","year":"2021","journal-title":"Diagnosis"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1113\/EP089260","article-title":"Myths and methodologies: Degrees of freedom\u2014Limitations of infrared thermographic screening for COVID-19 and other infections","volume":"107","author":"Mekjavic","year":"2022","journal-title":"Exp. Physiol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Arteaga-Marrero, N., Hern\u00e1ndez-Guedes, A., Ortega-Rodr\u00edguez, J., and Ruiz-Alzola, J. (2023). State-of-the-Art Features for Early-Stage Detection of Diabetic Foot Ulcers Based on Thermograms. Biomedicines, 11.","DOI":"10.3390\/biomedicines11123209"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1007\/s40200-024-01452-0","article-title":"Digital infrared thermography and machine learning for diabetic foot assessment: Thermal patterns and classification","volume":"23","author":"Guevara","year":"2024","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Haupt, M., Maurer, M.H., and Thomas, R.P. (2025). Explainable Artificial Intelligence in Radiological Cardiovascular Imaging\u2014A Systematic Review. Diagnostics, 15.","DOI":"10.3390\/diagnostics15111399"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Nasser, M., and Yusof, U.K. (2023). Deep Learning Based Methods for Breast Cancer Diagnosis: A Systematic Review and Future Direction. Diagnostics, 13.","DOI":"10.3390\/diagnostics13010161"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ryan, L., and Agaian, S. (2025). Breast cancer detection using infrared thermography: A survey of texture analysis and machine learning approaches. Bioengineering, 12.","DOI":"10.3390\/bioengineering12060639"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Aidossov, N., Zarikas, V., Mashekova, A., Zhao, Y., Ng, E.Y.K., Midlenko, A., and Mukhmetov, O. (2023). Evaluation of Integrated CNN, Transfer Learning, and BN with Thermography for Breast Cancer Detection. Appl. Sci., 13.","DOI":"10.3390\/app13010600"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"109955","DOI":"10.5312\/wjo.v17.i1.109955","article-title":"Science of heat mapping: Thermography in musculoskeletal disorders","volume":"17","author":"Jeyaraman","year":"2026","journal-title":"World J. Orthop."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Ahmed, F., Naz, N.S., Khan, S., Rehman, A.U., Ismael, W.M., and Khan, M.A. (2026). Explainable artificial intelligence (XAI) in medical imaging: A systematic review of techniques, applications, and challenges. BMC Med. Imaging, 26.","DOI":"10.1186\/s12880-025-02118-w"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Nowakowski, A.Z., and Kaczmarek, M. (2025). Artificial Intelligence in IR Thermal Imaging and Sensing for Medical Applications. Sensors, 25.","DOI":"10.3390\/s25030891"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"5016","DOI":"10.1109\/JBHI.2025.3543978","article-title":"Accurate core body temperature prediction for infrared thermography considering ambient temperature and personal features","volume":"29","author":"Shan","year":"2025","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Perpetuini, D., Formenti, D., Cardone, D., Trecroci, A., Rossi, A., Di Credico, A., Merati, G., Alberti, G., Di Baldassarre, A., and Merla, A. (2023). Can Data-Driven Supervised Machine Learning Approaches Applied to Infrared Thermal Imaging Data Estimate Muscular Activity and Fatigue?. Sensors, 23.","DOI":"10.3390\/s23020832"},{"key":"ref_47","first-page":"75","article-title":"Bias in artificial intelligence for medical imaging: Fundamentals, detection, avoidance, mitigation, challenges, ethics, and prospects","volume":"31","author":"Ponsiglione","year":"2025","journal-title":"Diagn. Interv. Radiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1204\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:36:57Z","timestamp":1782128217000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":47,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["medicina62061204"],"URL":"https:\/\/doi.org\/10.3390\/medicina62061204","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}