Thermography Basics

Yes! Infrared imaging (or thermography) uses no radiation or intravenous access and does not touch the body. The procedure is painless, completely safe, and FDA approved as an adjunctive imaging procedure (to be used in addition to other tests). Infrared imaging does not replace any other form of imaging (e.g. CT, MRI, mammography), but is designed to be used in addition to other tests to provide physiological information that cannot be obtained from any other examination procedure.

No! Based upon the available research data at the time, the U.S. Department of Health Education and Welfare (HEW) determined that thermography was beyond the experimental stage in 1972. Thermography was approved as an adjunctive imaging procedure by the FDA in 1982 (Federal Register, Vol 47, No. 20, pp 4419-4420, January 29, 1982). The FDA approved thermography as follows: “Telethermographic systems intended for adjunctive diagnostic screening for the detection of breast cancer or other uses” (Code of Federal Regulations – Title 21, Section 884.2980 Telethermographic Systems).

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We have also seen this news. If you look closely you will find a common thread among all of these negative reviews; the procedure is being done incorrectly. When personnel are properly trained, and guidelines are strictly followed, breast thermography can be a lifesaving technology. And, like any other procedure in healthcare, what is the expected outcome if things are done incorrectly?

No! The technologies are completely different. One cannot compare a functional imaging technology to a structural imaging tool. For example, an EKG does not replace an echocardiogram. The two technologies look at the heart in a completely different way, yet they complement each other.  Thermography provides information about the body that no other technology can offer, but it does not replace them. The reason why there are so many different medical imaging technologies is because no one technology can do it all. They all have strengths and weaknesses. 

Thermography does not replace any other form of imaging, but is designed to be used in addition to other tests to provide physiological information that cannot be obtained from other examination procedures. Thermography is an adjunctive physiologic imaging procedure that does not look inside the body. If you are interested in looking for structural changes such as broken bones, or viewing the colon, female reproductive organs, or the arteries of the heart, please see your doctor for the most appropriate test.

Absolutely not! However, do mammograms replace thermography? The answer to this is also a resounding no; the two tests complement each other. Thermography is adjunctive, it is to be used in addition to other imaging technologies as part of a woman’s regular breast health care. The consensus among health care experts is that no one procedure or method of imaging is solely adequate for breast cancer screening. The false negative and positive rates for currently used examination tests (including thermography) are too high for the procedures to be used alone. However, thermography may pick up thermal markers that indicate the risk of cancers not detected by other tests. An abnormal infrared image is also the single most important marker of high risk for developing breast cancer in the future. It is thermograpy’s unique ability to monitor the abnormal temperature (physiological) and blood vessel changes produced by pathological breast tissue that allows for extremely early detection. Since it has been determined that 1 in 8 women will get breast cancer, we should use every means possible to detect these tumors when there is the greatest chance for survival. Adding these tests together significantly increases the chance for early detection.

Keep in mind that no one test or imaging technology can provide a warning for 100% of all cases. As such, all tests and imaging technologies are adjunctive. As an example, no doctor would tell a woman that all she needs is a mammogram and that she does not need to come in for her yearly physical breast exam. All doctors know that a certain number of breast cancers will be detected on a physical exam of the breasts and not detected on a mammogram. As such, a mammogram is also adjunctive – it must be used along with a yearly physical exam of the breast. 

Another example of this “adjunctive” principle is the all too common experience of women having their yearly physical breast exam followed by their mammogram and then having to have a follow-up ultrasound to check on something seen on the mammogram. Now we are up to three “adjunctive” exams before a woman is told that everything looks fine. Now in some cases, if something needs to be watched on the mammogram and/or ultrasound, a woman might need to be called back in 6 months for another mammogram. Thermography might be the added technology that calls attention to something that needs a closer look.

It should be understood that all of these imaging technologies (thermography included) cannot tell you if you have breast cancer. They only provide a certain amount of suspicion based on what the individual technologies “see”. Only a biopsy can tell you if you have breast cancer. 

There just isn’t one single magic bullet that will do it all. As such, the best approach to providing every woman with the best in early breast cancer detection is a multi-modal approach (multiple modality – multiple tests).

The easy answer here is no. Thermography can only detect heat to a depth of 5mm from the surface of the body. As such, thermography cannot see into the cranial vault, thoracic cavity, abdomen, or pelvic basin. Remember the “visible man” model that was made for children? It had a clear plastic outer shell so that you could see the internal organs. With thermography, one cannot simply create a “visible man” image with heat at the surface of the body and think that you can transpose it to underlying anatomical structures. We have seen infrared images like this, but they are completely false and misleading.

Now, if an internal organ is damaged enough it may send a neural reflex message to the surface of the body creating an infrared marker (viscerosomatic reflex). This surface signal is rarely associated with the location of the underlying organ and is usually found in a remote location that only a well-trained board certified thermologist knows to look for. The problem is that by the time an internal organ is sending this signal there is usually a fair amount of damage. This viscerosomatic reflex can also burn out leaving no infrared marker. Combining this fact with an inability to offer an early warning means that thermography is also unable tell you that you are free of an internal disorder (rule out pathology). The technology is not sensitive enough to be used to screen for or rule-out internal disorders. There are much better tests and imaging tools that can provide for the early detection of pathologies of this type.

If you are concerned about a possible internal disorder, or the spread of cancer (metastasis), there are tests and imaging technologies that are better suited for this purpose. Please see your doctor for the most appropriate tests for your condition.