Objective: For the patients with recurrent CW disease there are limited imaging techniques that can assist clinicians in deciding the course of therapy and in evaluating the effectiveness of chemotherapeutic agents. The objective of this study is to establish the role of DII in estimating response and/or progression inside and outside the heated fields in patients with recurrent CW disease treated with TDox and HT.

Methods: For each eligible patient, the diseased areas were imaged in a temperature controlled room with a digital infrared camera (IRSnapShot®, Fluke Corporation, Everett, WA) prior to cycles 1, 3, 5 and post cycle 6. The DII images were transferred to Matlab (The MathWorks, Inc, Natick, MA) where an interface was developed for image registration, thresholding and data analysis. After registration, regions of interest (ROI) were selected around the target lesions (TL) and non-target lesions (nTL) defined by the treating physician. The average and maximum temperature in each ROI were recorded for baseline and for each subsequent post treatment image. Digital images were also taken, together with measurements of the TL and nTL. HT was administered for 1 hr using the BSD 500 superficial unit (BSD Medical, Salt Lake City, UT) with a temperature goal of 40-42°C. Due to the limited size of the heat applicators and the half life of the TDox, not all the CW disease was included in the heated fields.

Results: To date, DII analysis has been performed in seven patients, comparing clinical response in the TL, nTL, and in areas outside the heated fields. DII extracted parameters correlated well with disease response and/or progression in all areas analyzed. In general, both the average and maximum temperatures decreased in responding lesions, and increased in progressing lesions. A detailed analysis will be presented for all the patients and ROIs.

Conclusions: Thermographic changes as observed with DII correlate well with treatment response as demonstrated by clinical exam. DII analysis during the course of therapy contributes valuable information regarding treatment response that is not possible from visual inspection alone in patients with CW recurrence treated with TDox and HT. Supported by NCI Grant CA42745.