General Questions and Answers
What is thermal imaging?
Digital Infrared thermal imaging, or DITI, is a totally non-invasive, painless procedure with no radiation and no contact with the body. DITI is a clinical imaging technique that records the thermal patterns of your body. Your thermal images are used by your healthcare practitioner to help diagnose and monitor pain or pathology in any part of your body.
What is thermal imaging used for?
To help in determining the cause of pain.
-To aid in the early detection of disease and pathology
-To evaluate sensory-nerve irritation or significant soft-tissue injury
-To define a previously diagnosed injury or condition
-To identify an abnormal area for further diagnostic testing
-To follow progress of healing and rehabilitation.
Is thermal imaging FDA registered?
Yes. DITI was FDA registered in 1982.
Is thermal imaging covered by insurance?
Some insurance carriers cover thermal imaging. Please check with your individual carrier.
What parts of the body can be scanned?
Thermal images are taken of the whole body, or individual regions including breast, head, arm, leg, torso, etc. A lumbar assessment would typically include, low back, pelvis, and legs. A cervical assessment would typically include, head and neck, upper trunk, and arms.
Neurological testing can include a “cold stress test”; this involves placing a hand or foot into a bowl of cool water, or having a cool gel pad applied to any part of the body prior to scanning.
What happens when I have a thermal scan taken?
A thermal scan takes approximately 10 — 45 minutes depending on which part of the body is being scanned. You will remove all jewelry and clothes from the part of the body being scanned (for full body scans you leave underpants on), and will be asked to wear a surgical gown. For a breast scan, you will be ask to disrobe from the waist up.
While your skin is equalizing with the room temperature, you will be asked to fill out appropriate paper work.
What do I have to do to prepare for a thermal scan?
There are a few guidelines for preparing for a thermal scan:
-Do not have physical therapy, massage, or electromyography on the same day thermography is performed
-Do not participate in vigorous exercise 2 hours prior to the test.
-Do not smoke for 2 hours before the test
-Do not use lotions, deodorants, powder or liniments on day of test
-Stay out of strong sunlight on the day of test
-There are no dietary or medication restrictions on the day of your scan but no excessive hot or cold drinks prior to the test.
-Wear loose fitting clothes if possible.
*Do not come for a scan if you have a sunburn on your chest or the area of interest. You would need to wait until all the sunburned area has peeled off.
Who should interpret my scans and write the report?
All thermography interpretations should be reported by adequately trained and experienced doctors who hold board certification as Thermologists.
What certification should a thermographer have to perform this exam?
Thermographers should hold certification from a professional body with approved code of ethics and practice protocols that include quality control guidelines.
There are 3 areas that Thermography is useful:
- Inflammatory Phenomena - This could include early detection of cardiovascular disease, arthritis, Fybromyalgia or trauma such as strains, sprains or chronic pain.
- Neovascular Phenomena - Cancer is fed by the bodies own blood supply. This development of early vascularity is detected well before anatomical changes occur that will be detected with other screening tools.
- Neurological Phenomena - Chronic regional pain syndrome, nerve irritation can cause referred pain in other areas. Circulatory deficits are easily seen in thermographic images.
A full body screening covers all regions of the body with no less than 28 images. A region of interest can be used for focalized screening such as breast screening, thyroid, etc.
Thermography has been comprehensively researched for over 30 years. While it is not a replacement for Mammography, it may have many valuable assets including: earlier detection of neovascular(blood supply) patterns, adjunct to inconclusive mammograms, improved detection for women with dense breasts or implants or a reasonable alternative for women who refuse mammogram. Below is a sample of the over 800 studies in the index-medicus. They represent some of the important findings and value of thermography.
- In 1982, the FDA approved breast thermography as an adjunct diagnostic breast cancer screening procedure
- Of the extensive research conducted since the late 1950's, well over 300,000 women have been included as study participants
- The size of the studies are very large: 10k, 37k, 60k, 85k
- Some studies have followed participants up to 12 years
- Strict standardized interpretation protocols have been established for 15 years to remedy problems with early research.
- Breast thermography has an average sensitivity and specificity of 90%
- An abnormal thermogram is 10 times more significant as a future risk indicator for breast cancer than a first order family history
- A persistent abnormal thermogram carries with it a 22x higher risk of future breast cancer Extensive clinical trials have shown that breast thermography significantly augments the long term survival rates of its recipients by as much as 61%. When used as a multimodal approach (clinical exam +mammography+thermography), 95% of early stage cancers will be detected.
Yes, as a routine screening tool, it has been shown to be 97% effective at detecting benign vs malignant breast abnormalities. Another study tracked 1537 women with abnormal thermograms for 12 years. They had normal mammograms and physical exams. Within 5 years, 40% of the women developed malignancies. The researchers commented ""an abnormal thermogram is the single most important marker of high risk for the future development of breast cancer" These results have been repeated over and over again for nearly 30 years.
While a variety of studies have called into question the safety of cumulative exposures to radiation, this is not the case with Thermography. Thermography emits nothing, it only takes an image. Nothing touches you and it is quick and painless. This all makes Thermography great for frequent screening with no chance of danger.
The images are sent via a secured server to a professional group of physicians who are trained and board-certified in the protocols of reading Thermal images. A very formal interpretation is made and sent to us where we will review the results and make suggestions or referrals if necessary. You are given a copy of the report and frequently we send copies of the reports to physicians for their records.
What If I get Abnormal Results -- What Do I Do?
Thermography is not diagnostic but gives early risk factors. This is great news because an abnormal result from a thermogram often buys time so that natural interventions such as herbs, supplements and lifestyle changes can influence the outcome. At the least, the condition can be closely monitored safely until conventional interventions need to be applied. It is important to recognize that early detection is the key to a good outcome. As always, reviewing your results with your physician is recommended.
Stark. A., Way, S. The Screening of Well Women for the Early Detection of Breast Cancer Using Clinical Examination with Thermography and Mammography. Cancer 33: 1671-1679, 1974
Researchers screened 4,621 asymptomatic women, 35% whom were under age 35 y.o. and detected 24 cancers (7.6 per 1000) with a sensitivity and specificity of 98.3% and 93.5% respectively
Y.R. Parisky, A. Sardi, R. Hamm, K. Hughes, L. Esserman, S. Rust, K.Callahan, Efficacy of Computerized Infrared Imaging Analysis to Evaluate Mammographically Suspicious Lesions. AJR:180, January 2003
Compared results of Infrared imaging prior to biopsy. The researchers determined that Thermography offers a safe, noninvasive procedure that would be valuable as an adjunct to mammography in determining whether a lesion is benign or malignant with a 99% predictive value.
Gros, C, Gautherie, M. Breast Thermography and Cancer Risk Prediction. Cancer 45:51-56 1980
From a patient base of 58,000 women screened with thermography, researchers followed 1,527 patients with initially healthy breasts and abnormal thermograms for 12 years. Of this group, 40% developed malignancies within 5 years. The study concluded that "an abnormal thermogram is the single most important marker of high risk for the future development of breast cancer"
Spitalier, H., Giraud, D. et al. Does Infrared Thermography Truly Have a Role in Present Day Breast Cancer Management? Biomedical Thermology pp.269-278, 1982
Spitalier and associates screened 61,000 women using thermography over a 10 year period. The false negative and positive rate was found to be 11% (89% sensitivity and specificity). 91% of the nonpalpable cancers (T0 rating) were detected by thermography. Of all the patients with cancer, thermography alone was the first alarm in 60% of cases. The authors noted "in patients having no clinical or radiographic suspicion of malignancy, a persistent abnormal breast thermogram represents the highest known risk factor for the future development of breast cancer"
Jiang LJ, Ng FY et al A Perspective on Medical Infrared Imaging. J Med Technol 2005 Nov-Dec;29(6):257-67
Since the early days of thermography in the 1950s, image processing techniques, sensitivity of thermal sensors and spatial resolution have progressed greatly, holding out fresh promise for infrared (IR) imaging techniques. Applications in civil, industrial and healthcare fields are thus reaching a high level of technical performance. In many diseases there are variations in blood flow, and these in turn affect the skin temperature. IR imaging offers a useful and non-invasive approach to the diagnosis and treatment (as therapeutic aids) of many disorders, in particular in the areas of rheumatology, dermatology, orthopaedics and circulatory abnormalities. This paper reviews many usages (and hence the limitations) of thermography in biomedical field.