Thermography

Frequently Asked Questions about Medical Thermography

How does thermography detect health problems?

Breast thermography is a powerful tool for monitoring your breast health over time. The thermogram is a color-coded thermal "fingerprint" of the breast.  If the overall pattern appears to be normal, then future scans should show the same pattern. The greatest value of breast thermography comes from doing follow-up visits, with each thermogram serving as a snapshot of your breast’s overall condition and then being compared to previous scans.

By detecting tiny variations in temperature near the surface of the chest area, clinical thermography can help us assess abnormalities or physiological changes within the breast.  Inflammation and vascular changes associated with the breast abnormalities (e.g., DCIS and hyperplasia) as well as the early development of cancer can cause the affected tissue to be hotter than normal.  The infrared-imaging camera then captures these temperature variations.

Thermographic images use computer-generated color to reveal the varying temperatures, with yellow, orange and red indicating hotter areas. The images are also computer analyzed using mathematical algorithms to plot minute temperatures differences, often to within a sensitivity of 0.05 degrees Centrigrade. An experienced thermographer is then able to interpret this analysis in meaningful diagnostic ways.

How useful is breast thermography?

Thermographic imaging can aid in the detection, prognosis, and follow-up monitoring of breast cancer in both women and men. A review of 15 large-scale studies concluded that breast thermography had 90% sensitivity for breast cancer. Adding X-ray mammography and clinical exam increased the likelihood of detecting breast cancer by 98%. Again, however, for best results, it is essential to have regular thermograms, preferably at least once a year. By establishing a baseline, subtle yet significant changes can be observed over time. Thermography has been cleared by the FDA as an “adjunctive” tool for breast cancer screening, meaning that it is best used alongside mammography as well as self-exam and clinical examination.

Is there a correlation between the thermographic image and the stage of cancer?

Because thermography is detecting heat, and not actual physical tissue changes, it may reveal a problem, such as cancer, long before that problem can be detected by other kinds of imaging technologies, such as X-rays or CAT scans. Thus, thermography can provide warning signs far in advance, even before a tumor is picked up by mammography. Indeed, research indicates that thermography can detect the earliest signs of breast cancer up to 8 to 10 years before other methods. Moreover, the degree of thermographic abnormality has been shown to be directly proportional to the aggressiveness of the cancer.

Thermography can also show a return toward “normal,” thereby helping to provide evidence that a cancer therapy (whether it be surgery, radiation, chemotherapy or an alternative method) is effective.* It can also monitor the effectiveness of other kinds of therapies used to treat other health issues, from arthritis to cluster headaches to back problems.

*References available upon request.

Can thermography play a role in assessing other health issues?

Thermography is helpful in assessing a variety of conditions.  In spinal disorders, for example, pressure on the spinal nerves causes the surrounding tissue to heat up, and this becomes visible on the thermogram. Similar to breast thermography, follow-up scans of the spine can indicate resolution of the problem by showing a reduction or return to normal of the previously elevated temperature.

Other examples include musculoskeletal and joint inflammation. These problems are readily visualized and assessed with thermography, regardless of whether the problem is caused by trauma, overuse, crystal deposits, or a rheumatoid process. The extent of the inflammation as well as resolution of the problem can be clearly seen. And thermography is the only reliable and non-invasive way to document Complex Regional Pain Syndrome (formerly known as Reflex Sympathetic Dystrophy).  

Who should have a thermogram?

While many of our clients are referred to us by their physicians, individuals also decide on their own to monitor their health as part of a preventative health strategy, to confirm suspicions of a problem, and/or to monitor the effectiveness of a therapy they may be undergoing.

For example, thermography may reveal evidence of peripheral neuropathy in diabetics long before they experience symptoms, providing them time to consult with their physician to head off more serious problems.

Since inflammation is generally recognized in mainstream medicine as evidence that some aspect of the body is in distress, a way to image internal inflammation can be an important part of staying healthy. Chronic inflammation usually precedes the development of a health problem. Thermography is an excellent way to gauge inflammation. Many people choose to have a full-body thermogram every year or so for just this reason. This way they can reveal any problems that may be occurring, and they can also reveal changes over time that may provide clues to a developing health condition.  The full-body scan should be accompanied by a physical exam conducted by a qualified physician.

Women who add thermography to their breast health screening routine (mammography, self-exam and clinical exam) substantially increase their chances of catching a potential cancer. If they start thermographic screening early enough, they can often catch a tumor while it is still tiny. In this way, they give themselves time to coordinate with their physician to choose the most effective and least invasive therapies. Women who have breast implants and who have fibrocystic breast tissue may also benefit from thermography, as X-ray mammography is less accurate for these women. Young women also benefit. If they have a family history of breast cancer, they can start screening young, in their 20's, without risk of radiation exposure. (Thermography is completely radiation-free.) With regular thermograms, they are likely to detect any troublesome issues long before they are ready to start screening with regular mammography. Thermography does not replace mammography, but it provides a different kind of information that can serve as in important source of knowledge about overall breast health.

How should I prepare for my thermography scan?

Please download the file: Thermography Pre-Scan Instructions

Why do I have be cooled down before the thermographic images are taken? 

The brief (15 minute) cooling down period is important to get your body into a vasoconstricted state. You can think of this as reaching temperature equilibrium, so that when the images are taken, any temperature differences that show up can be more confidently associated with an abnormality.

There are many external and internal conditions that influence surface body temperature, from whether you have been out in the sun shortly before coming to your appointment to whether you just ate a large meal and your gastrointestinal track is revved up digesting food to whether you just smoked a cigarette (which constricts some of your blood vessels). So both the cooling down period, which is done in an environmentally controlled room (kept at between 68 and 70 degrees F), and your following the pre-screening instructions are important. 

Do I have to do a “cold challenge test”? 

No, except for clients undergoing a scan for Chronic Regional Pain Syndrome, where a warm/cold challenge is necessary to provide evidence of the disorder.

A cold challenge involves immersing a hand, or other extremity, in very cold water before an image is taken. This was a procedure that was in widespread use, especially for breast cancer screening, for many years, but it has since been shown to be ineffective and unnecessary.

Use of cold challenge tests are outdated for almost all uses of thermography except Chronic Regional Pain Syndrome. In fact, if a client is shivering, the infrared image quality could be degraded. So no, you won't have to undergo a cold challenge test except under very rare circumstances.

For breast cancer screening, imaging the nose after a cooling-off period is enough to demonstrate that the proper vasoconstriction has occurred for thermal images to be useful diagnostically, which is why for a breast scan we always also take at least one image the face. 

What is the rating scale for breast screening images?

In addition to the information about breast thermography on this and other pages of the thermography section of this website, it is important for you to understand the rating system currently used by almost all thermographers.

Based on the results of your thermogram, your breast images will be rated along a scale of TH-1 to TH-5. The meaning of each rating, and a representative thermographic image that falls into that rating category, is provided below. Please note, however, that this is an overview only. Only an experienced thermographer can properly interpret and rate any thermographic image, and sophisticated computer processing is an integral part of that analysis. You can read more about the origin of this rating scale by selecting the "Ville Marie Breast Thermography Grading Scale" in the Thermography Forms dropdown list at the top of this page.

TH-1 Normal Exam

 

Breasts are uniformly cool, without hot spots or vascular markings. 

TH-2 Normal/Vascular

Thermographic image of female breasts normal vascular

Breasts show slight to moderate vascular markings, but they are mostly symmetrical. 
Breasts are uniform in temperature. Follow-up over time will show any changes in the 
vascular patterns.

TH-3 Equivocal

Thermographic image of female breasts equivocal patterns

Breasts show strong although symmetrical vascular patterning, with a slightly warmer 
area near the left nipple. Warrants follow-up screening in four to six months to monitor 
for changes.

TH-4 Abnormal

 Thermographic image Asymmetrical vascularity of left breast

This image shows abnormal asymmetrical vascularity of left breast,
with a significant temperature increase of two degrees F in part of that breast.
Follow-up testing by other methods, such as X-ray mammography, is required.

TH-5 Very Abnormal.

 Thermographic image Marked asymmetrical vascularity of medial left breast, with a substantive warming of that entire breast

In this image there is marked asymmetrical vascularity 
of the medial left breast, with a substantive warming of that entire breast. 
Follow-up testing was required. In this case, following a mammogram, 
a biopsy was performed, and a 1-inch carcinoma was found.

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