Necrotizing Enterocolitis (NEC) is a devastating intestinal disease associated with a high rate of mortality and long-term morbidity. Treatments can be successful if NEC is diagnosed early, but no reliable methods exist. Infrared imaging can detect tissue inflammation and thus has the potential to be an early diagnostic tool for NEC. Infants with no clinical or radiographic signs of NEC, and a group of infants with evidence of at least Bell's Stage 2 NEC were enrolled in our study. Infants underwent bedside infrared imaging for 60 seconds. The dataset consists of twenty normal infants and nine infants with NEC. In early work, in infants with NEC, the upper-to-lower (UL) region temperatures differed significantly, where no significant difference in the UL region was found in normal infants. No significant difference was found in left-to-right (LR) region temperatures for both groups. The decision tree classifier produced good results in terms of specificity, sensitivity, and standard deviation for ten trials. Results for the medians were: 91%+/-0.07%; 84%+/-18%; and for the means they were: 86%+/-0.04%; 79%+/-21% [1]. In this work, we assessed the impact of image enhancement in discriminating between infants with NEC and those without. The approaches explored were: (i) noise reduction; (ii) background removal; and (iii) contrast enhancement. Preliminary results show marked improvement in detecting infants with NEC. Future work will automate the analysis and carry-out a prospective study to attempt detecting NEC at earlier stages. Other image analysis techniques will be tested to enhance the performance of our new diagnostic tool.

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Necrotizing enterocolitis (NEC), is a devastating inflammatory disease of infants for which there is no cure and exact causes remain unknown. Diagnoses are limited to radiographic findings and in most institutions Modified Bell's Criteria is used, neither are capable of reliable early detection. In this thesis, a novel method of abdominal infrared thermal imaging is proposed that allows direct measurements of skin temperature, which are capable of unveiling thermal abnormalities that may indicate intestinal inflammation characteristic of NEC. Abdominal thermal symmetry analysis was performed, results obtained from the 20 normal and the 9 NEC affected infants were statistically compared. A higher degree of thermal asymmetry was seen with the NEC group in comparison to the Normal group, notably when image enhancement techniques were done. We are hopeful that this new non-contact, non-ionizing method may potentially offer an early diagnostic tool.

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