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Thermography (also called thermal imaging or infrared imaging) was approved by the U.S.
Food and Drug Administration (FDA) in 1982 as a supplement to mammography
in helping to detect breast cancer. Thermography can help determine whether a local
abnormality in breast tissue temperature is present, which may indicate the presence of
disease. Though thermography is FDA approved, the exam has not gained acceptance in
the medical community as a necessary or effective tool in breast cancer detection.
According to the American College of Radiology, thermography has not shown value as a
screening, diagnostic, or adjunctive imaging tool.
While thermography may be appealing to some women because it is a pain-free exam, most
physicians do not recommend thermal imaging. Scientific research over the last 20 years
has shown that thermography is not reliable for detecting breast cancer. In 1977, the
Beahrs Committee of the National Cancer Institute (NCI) recommended that thermography be
discontinued as a routine screening modality in the NCI’s Breast Cancer Detection
Demonstration Project.
Since then, studies have failed to show a clear benefit of thermal imaging in helping
to detect breast cancer. In their 1998 document, "Evaluation of Common Breast
Problems: Guidance for Primary Care Providers," Barbara Smith, MD, PhD and her
colleagues wrote, "currently, thermography has no role in breast cancer screening or
diagnostic evaluation." Several other reports have drawn similar conclusions. That is
not to say that improved thermography technology may not one day aid in the breast cancer diagnostic process (see computerized thermal
imaging sections below); however, at the moment, thermography is not widely accepted as an
effective means of detecting breast cancer.
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Inside view of computerized
thermal imaging system with
mirrors that deflect infrared
waves from a patient's breast
to a camera below. Image
courtesy of CTI, Inc. |
Computerized thermal imaging (CTI) is a new, non-invasive imaging method that is being
developed using the principles of traditional thermography but with the addition of
digital image reconstruction. Computerized thermal imaging (CTI) is a heat sensing and
processing system that uses a thermal sensitive camera to capture a digital image based on
heat radiating from the body. A computer-assisted interpretation of the digital image
helps to determine whether a local abnormality in breast tissue temperature is present,
which may indicate the presence of disease. To date, CTI is only available for eligible
women who participate in CTI clinical trials; the technology has not been approved by the
U.S. FDA.
Currently, clinical trials are being conducted at five hospitals across the United
States to determine whether the CTI technology may be useful as an adjunct (supplement) to
mammography in the breast cancer diagnostic process.
The main component of the CTI technology is the highly sensitive, high-speed infrared
camera. The camera is designed to detect infrared heat given off by the body. After the
radiologist has acquired images of the breast tissue, the CTI system uses sophisticated
image analysis algorithms and a computer to reconstruct the images to show individual heat
patterns. These images differentiate between normal and abnormal heat patterns. The CTI
examination consists of the patient being positioned on a special examination bed with the
breast suspended in an opening in the top of the bed. The thermal camera is located inside
of the bed, focused at the examination area. The physician will use the thermal camera to
take a series of images of the breast. The procedure is then repeated with the
patient’s other breast. As with traditional thermography, no radiation or breast
compression is used during CTI.
After the breast images have been taken, they are analyzed by a computer algorithm and
displayed for interpretation by the physician. Breast images are displayed in different
colors (red, orange, and yellow) on a computer monitor for the physician to review. Any
suspicious area (abnormal heat area) is marked on the digital breast image. The
radiologist may then decide whether further breast imaging is necessary. The CTI
technology is designed to electronically store the digital breast images and provide the
patient with an electronic copy of the images, which may be helpful if she visits another
imaging facility.
Malignant (cancerous) image:
The left image is the raw thermal image. The right image is a
magnified view of the processed image that corresponds to the area of suspicion selected
by the green square in the left image. This image shows a very high probability of
malignancy (cancer). This patient was rated a BIRAD 4 (suspected
malignancy, biopsy recommended) by mammography and confirmed to have ductal
carcinoma in situ by biopsy. Images courtesy of Computerized Thermal Imaging, Inc.
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