A research blog about thermology, and its clinical use in detecting breast pathology.
What is thermology?
Digital infrared thermal imaging (DITI) is a non-invasive,
non-contact system of recording body temperature by measuring infrared radiation emitted by the body surface.
This technology has many applications in medicine. Its use in the field of medical oncology lies in the fact that tumours generally have an increase in blood supply and angiogenesis, as well as an increased metabolic rate, which in turn translates into increased temperature gradients compared to surrounding normal tissue.
Detecting these infrared “hotspots” and gradients can thereby help to identify asymmetries within the breast tissue.
Infrared thermography has been in use in medical diagnostics since the 1960s, and in 1982 was approved by the FDA as an adjunctive tool for the diagnosis of breast cancer. Unfortunately here in Australia, we are so far behind in how thermal imaging can help when assessing physiological changes in the clinical field compared to other countries.
Since its inception, major advances have been made in infrared thermal imaging technology, with digitalized high-resolution imaging.
The digital infrared thermography cameras of today are capable of sensing changes in temperature at .05°C or better and do not require any patient contact.
Clinical studies
The exerts below from the clinical study were published by the American Society of Breast Surgeons and in The American Journal of Surgery
In this study we assess the effectiveness of a DITI system, the Sentinel BreastScan in detecting breast pathology in a group of patients with suspicious findings on either mammography or ultrasound that all underwent biopsy in a prospective, double-blinded trial.
METHODS:
In this prospective clinical trial, 92 patients for whom a breast biopsy was recommended based on prior mammogram or ultrasound underwent DITI. Three scores were generated: an overall risk score in the screening mode, a clinical score based on patient information, and a third assessment by the artificial neural network.
RESULTS:
60 of 94 biopsies were malignant and 34 were benign. DITI identified 58 of 60
malignancies, with 97% sensitivity, 44% specificity, and 82% negative predictive value depending on the mode used. Compared to an overall risk score of 0, a score of 3 or greater was significantly more likely to be associated with malignancy (30% vs 90%, P .03).
CONCLUSION:
DITI is a valuable adjunct to mammography and ultrasound, especially in women
with dense breast parenchyma.
In this prospective clinical trial of 92 women undergoing DITI with suspicious breast lesions identified on prior mammogram or ultrasound, we have shown that the SBS can detect breast pathology with sensitivity up to 97% and a negative predictive value of 82%. DITI is painless, noninvasive, does not emit harmful radiation, has no patient risk, provides immediate results, and is relatively inexpensive.
Compared to magnetic resonance imaging (MRI)—an adjunctive diagnostic tool for breast malignancy gaining more popularity—DITI is considerably more affordable to the patient.
The ability of DITI to detect tumors relies on the assumption that tumors have a different biology from surrounding normal tissue. One study found a correlation between microvessel density of breast malignancies and thermographic hot spots, thus providing a mechanistic explanation
for the use of DITI in cancer diagnosis.
In conclusion, we have shown that a modernized DITI system can be a useful adjunctive test in detecting breast cancer with 97% sensitivity in this prospective clinical trial
of 92 patients.
The conclusion
It is extremely encouraging to have a 97% sensitivity rate for detecting already confirmed pathology! There is no other single diagnostic testing that can offer that kind of statistics.
Why is this incredible clinical technology not more mainstream here? I ask myself the same question often, and unfortunately don't have an easy clear-cut answer.
Especially when there are dedicated clinics with teams of doctors doing breast scans oversees to reduce breast trauma, and other countries steering away from what we are told is the only way.
Through the tens of thousands of ladies who trust the science of thermology around the world, we know the value it provides when getting a full picture of our breast health.
The proof is in the temperature data provided in your reports, it's in the improvements seen when alternative treatments are being used and WORKING, and it's in the independent peer-reviewed research studies like the above.
While this does not claim to use thermology instead of traditional diagnostic tools, it is a valuable way to get a physiological snapshot of what may be happening not just in our breasts, but in our whole body. Including lymph congestion which can be an ongoing concern particularly post-node removal.
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References
1. Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases.Nature 2000;407:249 –57.
2. Jones BF. A reappraisal of the use of infrared thermal image analysis inmedicine. IEEE Trans Med Imaging 1998;17:1019 –27.
3. Yahara T, Koga T, Yoshida S, et al. Relationship between microvesseldensity and thermographic hot areas in breast cancer. Surg Today2003;33:243– 8.
4. Gautherie M, Gros CM. Breast thermography and cancer risk prediction. Cancer 1980;45:51– 6.
5. Sterns EE, Zee B, SenGupta S, et al. Thermography. Its relation topathologic characteristics, vascularity, proliferation rate, and survival of patients with invasive ductal carcinoma of the breast. Cancer 1996;77: 1324 – 8.
6. Head JF, Elliott RL. Thermography. Its relation to pathologic characteristics, vascularity, proliferation rate, and survival of patients with invasive ductal carcinoma of the breast. Cancer 1997;79:186 – 8.
7. Ng EY, Kee EC. Advanced integrated technique in breast cancer thermography. J Med Eng Technol, 2008;2:103–14.
The American Journal of Surgery (2008) 196, 523–526
