Digital Infrared Thermal Imaging Studies

Effectiveness of a noninvasive digital infrared thermal imaging system in the detection of breast cancer
Nimmi Arora, M.D., Diana Martins, B.S., Danielle Ruggerio, B.S.,
Eleni Tousimis, M.D., Alexander J. Swistel, M.D., Michael P. Osborne, M.D., Rache M. Simmons, M.D.*
Department of Surgery, New York Presbyterian Hospital–Cornell, New York, NY, USA
BACKGROUND: Digital infrared thermal imaging (DITI) has resurfaced in this era of modernized computer technology. Its role in the detection of breast cancer is evaluated.
METHODS: In this prospective clinical trial, 92 patients for whom a breast biopsy was recommended based on prior mammogram or ultrasound underwent DITI. Three scores were generated: an overall risk score in the screening mode, a clinical score based on patient information, and a third assessment by artificial neural network.
RESULTS: Sixty of 94 biopsies were malignant and 34 were benign. DITI identified 58 of 60 malignancies, with 97% sensitivity, 44% specificity, and 82% negative predictive value depending on
the mode used. Compared to an overall risk score of 0, a score of 3 or greater was significantly more likely to be associated with malignancy (30% vs 90%, P  .03).
CONCLUSION: DITI is a valuable adjunct to mammography and ultrasound, especially in women with dense breast parenchyma.
© 2008 Elsevier Inc. All rights reserved.


INFORMATIONAL REPORT OF THE COUNCIL ON SCIENTIFIC AFFAIRS Thermography in Neurological and Musculoskeletal Conditions John H. Moxley, III, M.D., Chairman Abstract


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INFORMATIONAL REPORT OF THE COUNCIL ON SCIENTIFIC AFFAIRS Thermography in Neurological and Musculoskeletal Conditions John H. Moxley, III, M.D., Chairman

Thermography is a safe adjunctive physiological procedure which may be useful in the diagnosis of selected neurological and musculoskeletal conditions. Thermography is noninvasive and does not involve the use of ionizing radiation. Thermography may facilitate the determination of spinal nerve root and distal peripheral nerve dysfunction. Thermography also contributes to the evaluation of possible autonomic nervous system dysfunction and of spinal disorders.Thermography may be useful in documenting peripheral nerve and soft tissue injuries, such as muscle and ligament sprain, inflammation, muscle spasm, and myositis. Thermography is helpful in the diagnosis of reflex sympathetic dystrophy and can be used to follow the course of patients after spinal surgery. In those applications, thermography does not stand alone as a primary diagnostic tool. It is a test of physiological function that may aid in the interpretation of the significance of information obtained by other tests.


AVAILABLE PROOF OF EFFICACY: Evidence of prospective studies. Prospective studies have shown the excellent sensitivity and good correlation of thermography with other imaging methods. A high correlation of 84% has been demonstrated in studies comparing thermography and CT scanning of patients with low back pain and sciatica. Surgical treatment has also shown similar high rates of sensitivity. A large study of 805 patients with upper and low back pain confirm good correlation between thermographic evaluation and myelography, CAT scanning and EMG. The two objective tests for documentation of sensory radiculopathy, thermography and somatosensory cortical evoked potential’s, show equal sensitivity in the diagnosis of clinical lumbosacral radiculopathy.

SAFETY: The procedure is totally non-invasive and does not involve ionising radiation. It is without patient risk.

CONCLUSION OF REVlEW: Thermography is a safe and effective means for evaluation of vasomotor instability due to irritation or injury of spinal roots, nerves or sympathetic fibres. It is to be considered an adjunctive test and not solely diagnostic except in cases of reflex sympathetic dystrophy. While one cannot extend the technique of thermography to indicate the central phenomena of perception of pain, it is useful in detecting associated vasomotor instability and complex pain states associated with arthritis, soft tissue injuries, low back disease or reflex sympathetic dystrophy and does provide objective data to identify dysfunction in roots that are irritated in the lumbar spine, peripheral nerves that are irritated, and damage to the sympathetic nervous system