Q. How does clinical thermography differ from other screenings?
A. Clinical thermography is a screening of physiology (the body’s function). Screenings such as x-rays, mammograms, sonograms (ultrasound), etc. are screenings of anatomy (the body’s structure) . With specific reference to breast cancer: mammograms and sonograms indicate the structure of a “lump” or area of suspicion. Thermography indicates the function associated with active developing pathology. The function of a growing breast cancer is known as angiogenesis. “Angiogenesis” (when referring to cancer) is the formation of new blood vessels that supply oxygen and nutrients to cancerous tissue. Inflammation and early stages of angiogenesis in breast tissue can be detected thermographically as many as ten years before a “lump” is large enough to be detected by structural tests or breast self exam.
Q. How does thermography work?
A. The human body is an almost perfect emitter of infrared radiation. Infrared radiation is emitted through the skin’s pores. The thermography camera collects your body’s thermal emissions and creates an image called a thermogram. A thermogram is basically a map of your body’s thermal patterns that indicate health or illness.
Q. What are the most common uses of clinical thermography?
A. Clinical thermography is most commonly used as a breast cancer screening tool. However, screenings range from specific regions of interest to full body screenings. As a screening of function, thermography shows the physiological reactions your body is having to conditions that are present, including very early stage reactions. Inflammation is a common example of a functional reaction. Compared with other screenings that show inflammation (e.g. MRI, CT Scans, Endoscopy, PET Scans, etc.) thermography is noninvasive and involves no radiation or dyes. Thermography is significantly more affordable than the screenings mentioned above, with costs in the hundreds of dollars as opposed to costs in the thousands. Thermography is an excellent indicator of both suspected and unidentified health conditions. Some conditions commonly indicated by clinical thermography are: thyroid problems, carotid artery occlusion, elevated C-Reactive Protein levels, diabetes, cardiac dysfunction, arthritis, carpal tunnel, TMJ, etc. The list is extensive. NOTE: Thermography is high in sensitivity and low in specificity. For example: thermography can show patterns indicating general heart dysfunction. Additional testing would be required to identify the specific condition.
Q. Is clinical thermography a replacement for mammography?
A. No. Thermography vs. mammography is an “apples and oranges” comparison. Breast thermography is a breast cancer screening option. It is not a replacement for mammography. ” On the other hand, there are many women (and men) for whom mammography is either inconclusive or not desired. Some breast tissue is so dense or cystic or fibrocystic that accurate readings of mammograms and ultrasound can be difficult to impossible. Because clinical thermography uses no radiation and no pressure, it is 100% safe and 100% pain-free. There is no contact with the equipment.
Q. I hear from some people that you need to "cold stress" the patient. What is "cold stressing"? Do I really need to do it?
A. Cold stressing is a test to measure sympathetic function, It is a useful test for a number of conditions including RSD (CRPS). Protocols used with the Meditherm system for breast screening do not require routine cold stressing but it may be requested by a referring physician or reading thermologist.
Q. Who certifies your thermographers?
A. Thermography technicians are trained and certified by the American College of Clinical Thermology (ACCT). The ACCT is an accredited medical association.
Q. Who reads the images and reports?
A. Images are sent to an interpretation service who employ medical doctors, MDs, who are all board certified as Thermologists by the American College of Clinical Thermology. These doctors have many years experience and are able to ask for second opinions whenever necessary.
Q. I was told that grayscale thermograms were higher resolution than color, why don't you show grayscale?
A. Nowadays there is no difference in resolution between color and grayscale with modern digitized images. When images were viewed on an old TV screen, it took three phosphors on the cathode ray tube to make one color dot….. it only takes one phosphor to make a shade of grey, the resolution in black and white therefore, would be three times greater than it was in color.
Q. What is the difference between high definition thermography and other types ?
A. Just about all modern cameras provide high-definition images. The ‘definition’ of a thermogram relates to how many individual temperature measurements are taken to build the image. The actual definition is not as important as how accurate and sensitive those temperature measurements are. The higher the definition, the better the picture will look but this does not mean that the accuracy is any better.
Describing a thermogram as ‘high definition’ maybe confusing and misleading as most so-called high-definition images are produced by software manipulation of the data.
Low definition would be considered below 160 x 120 pixels. Industry standard is between 160 x 120 up to 320 x 240 pixels. High-definition would be considered above this and can be as high as 640 x 512 pixels.
Q. Why do I need to come back in three months for another breast study ?
A. The most accurate result we can produce is change over time. Before we can start to evaluate any changes, we need to establish an accurate and stable baseline for you. This baseline represents your unique thermal fingerprint, which will only be altered by developing pathology. A baseline cannot be established with only one study, as we would have no way of knowing if this is your normal pattern or if it is actually changing at the time of the first exam. By comparing two studies three months apart we are able to judge if your breast physiology is stable and suitable to be used as your normal baseline and safe for continued annual screening. The reason a three-month interval is used relates to the period of time it takes for blood vessels to show change…… a period of time less than three months may miss significant change…….. a period of time much more than three months can miss significant change that may have already taken place. There is NO substitute for establishing an accurate baseline. A single study cannot do this. Once a baseline has been established, annual screening is recommended.
Q.What is the accuracy of mammography and breast thermography?
A.The accuracy of mammography varies greatly depending upon factors such as the patient’s age, tissue density and breast cancer history. Typically mammography accuracy ranges between and 80% and 90%. The standard accuracy range for breast thermography is 83% to 90%. However, a study published in the 2009 Journal of Medical Systems reports that thermography aided by analytical software sensors has an accuracy rating of 94.8%. Ideally a functional screening (thermography) and a structural screening (e.g. ultrasound, mammography, etc.) are used adjunctively. Combining structural and functional views raises breast screening accuracy to above 95%.
Q. Can women with implants have breast thermography?
A. Yes! Again, because thermography is a screening of function and not form, the implant structures do not interfere with the thermal patterns.
Q. What can thermography miss?
A. Thermographycan miss encapsulated or inactive cancers. The thermographic camera detects function. Therefore, functionless or inactive cancers can go undetected in a thermographic screening. Sometimes there can be other thermal indicators of inactive cancers or encapsulated tumors but it is important to remember that clinical thermography is an adjunctive screening. It is necessary to recognize both what thermography does do (show function/physiology) and what it does not do (show structure/anatomy). It is important to balance functional and structural screenings. There is a growing trend toward the use of thermography and sonograms/ultrasound to balance structural and functional breast screenings. Neither screening uses radiation or pressure.
Q. How long does it take to get results?
A. Typically you will receive your results within 7 to 10 business days. If results are needed within 24 hours, this can be done. There is an additional fee for urgent interpretation. Results can be sent directly to your physician.
Q.Will my health professional understand the results?
A. The reports are straightforward using standard medical terminology. If the patient’s health professional needs any clarification, please ask the health professional to contact the thermographer or the interpreting thermologist. (Please note that the thermologist cannot consult directly with the patient. A consultation between the thermologist and the patient’s health practitioner can be arranged.
Q.Does it matter what time during the menstrual cycle the test is performed?
A. No. Any hormonal changes are systemic and do not alter the temperature differentials or patterns.
Q. If there is a suspicious finding, what should I do?
A. The interpreting thermologist (medical doctor) will recommend seeking further clinical evaluation. Sometimes specific diagnostic tests will be suggested. The information given in the report will be useful to the patient’s health professional in the decision making process. It is the patient’s own health professional who must advise on additional testing and clinical evaluation of any suspicious findings.