Avaliação da utilização da termografia infravermelha no diagnóstico diferencial de lesões neoplásticas e não-neoplásticas em língua

Abstract

Introduction: The tongue, specifically the lingual apex and lateral border, is a common anatomical site for the development of lesions, both neoplastic and non-neoplastic, affecting individuals of all ages and both sexes. Among the non-neoplastic lesions frequently affecting the tongue, proliferative non-neoplastic processes (PNNP) are notable due to the region's susceptibility to chronic trauma. Neoplastic lesions include benign tumors such as hemangiomas, neuromas, fibromas, lipomas, and malignant tumors such as squamous cell carcinoma, which is one of the most common neoplasms in the oral cavity. Aims: Evaluate the use of thermal imaging in the differential diagnosis of neoplastic (NL) and non-neoplastic lesions (NNL) on the tongue. Methodology: The sample consisted of 87 individuals, with 54 thermograms performed, divided into two groups: test group (16 thermograms of patients with NL and 38 thermograms of patients with NNL) and control group (120 thermograms of patients without tongue lesions). Thermal images of the lesions were obtained using the FLIR T650sc® Infrared portable camera, at a distance of 30 cm between the camera and the patient in normofrontal and normolateral positions, resulting in 174 thermograms. Biopsies were performed when necessary to confirm the histopathological diagnosis. The FLIR Thermal Studio program was used for thermogram analysis. Data analysis was conducted using IBM SPSS (version 22.0 for Windows, IBM Corp., Armonk, NY, USA), Jamovi (Computer Software Inc., Sydney, Australia), and RStudio (RStudio Team: Vienna, Austria, 2021), with Komolgorov-Smirnov, Pearson's Chi-square, Welch's t-test, and robust Two-Way ANOVA tests applied. Results: This research involved a total of 87 participants were involved, 69% (n = 60) female and 62.1% (n = 54) non-white individuals. The test group comprised 70.4% (n = 19) patients with NNL, while 29.6% (n = 8) had NL. In the NL group, hemangioma and neurofibroma were prevalent, 25.0% (n = 2) each, and in the NNL group, geographic tongue was the most frequent at 26.3% (n = 5). No significant differences were found in the average temperatures between the test (ΔTfrontal=31.46; ΔTlateral=30.67) and control (ΔTfrontal=31.32; ΔTlateral=30.84) groups, nor between NL (ΔTfrontal=30.99; ΔTlateral=30.57) and NNL (ΔTfrontal=31.65; ΔTlateral=30.73) (p>0.05). However, in the test group, significant differences were found in average temperatures according to sex (p = 0.049), with men showing higher average temperatures than women. NL and NNL on the dorsum of the tongue (ΔTaverage = 32.57) showed higher average temperatures than lesions on the apex and border (p = 0.036). Conclusion: This research expands the understanding of the role of TI in diagnosing NL and NNL on the tongue, showing positive results in detecting NNL. Significant temperature variations were also observed in different areas of the tongue. Further studies with larger samples are needed to establish a definitive diagnostic correlation between NL and NNL using TI.