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WORKSHOP: Termoviziunea medicala – de la teorie la practica
Joi, 04 Octombrie 2018 12:43 Publicat in Manifestari
2 – 3 NOIEMBRIE 2018 BRAȘOV – sediul LIAMED
- Cancerul de sân si termoviziunea medicala. Dr. Miodora BOGDAN
- Termoviziunea si ozonoterapia in piciorul diabetic. Dr. Emilia COMSA
- XIV Congress of the European Association of Thermology. Dr. Miodora BOGDAN
- Actualități in Termoviziunea medicală. Dr. Gheorghe SERBU
- Principii ale termoviziunii medicale si aplicatii in medicina. Dr. Gheorghe SERBU
Breast thermography: What you need to know
Miercuri, 03 Octombrie 2018 14:08 Publicat in ManifestariBreast thermography: What you need to know
Breast thermography is a non-invasive and painless test, with no radiation involved. It can detect and monitor early warning signs of breast cancer.
This type of breast cancer screening is particularly useful for people under the age of 50. This is because mammography, another type of screening, can be less effective for this group.
However, thermography is not an alternative to mammography. Mammography remains the main way of screening for early signs of breast cancer and uses low doses of X-rays.
How thermography works?
The way thermography, or thermal imaging, works is based on how cancer cells grow. When cancer cells are growing and multiplying in a tumor, blood flow is very fast in that area.
Increased blood flow makes skin temperature increase. This rise in skin temperature is what breast thermography is aiming to detect.
There is a debate among doctors about how useful thermography is as a way to diagnose breast cancer. The American Cancer Society have said that it will take time to see if it is better than, or equal to, current tests.
Process of a thermograph
Breast thermography is a non-invasive physical test that lasts for around 15 minutes. It is also "non-compressive," which means that it does not put force on, or squeeze, the breast, as is the case with breast mammography exams.
Some people are worried about the force put on breasts in a mammogram, so prefer the idea of a thermograph. However, people should not be put off by a mammogram as it is currently considered the gold standard for breast cancer screening.
Thermography uses digital infrared imaging to detect subtle changes in the breast based on symmetry. It looks for clear abnormalities in one breast in comparison to the other. This makes it more difficult to use on individuals who have undergone a mastectomy.
The process can be undertaken in a doctor's office. During the thermograph a person will be asked to stand around 6-8 feet away from the camera.
What thermographs detect
To understand a thermograph, it is necessary to know two things about cancerous breast tissue, compared to normal breast tissue. These are:
there is more metabolic activity (biochemical reactions)
there is increased blood flow
These aspects of breast cancer tissue result from the cancer cells doing all they can to maintain and grow. Another side effect of this is a rise in skin temperature.
Ultra sensitive cameras and computers can detect this increase in temperature. They produce high-resolution images.
Using thermography with other tests
Thermography can be used alongside other tests, such as mammographic screening.
Normally if a thermograph alone is used, the images taken will be kept on record and used for future evaluations. The idea is that an initial breast thermography test, which can be used on people as young as 18, will provide a baseline.
Future tests can then be compared to this baseline to see if there are any changes or abnormalities that develop. These might be part of a yearly physical examination.
Follow up tests
If abnormalities are detected, then follow-up procedures will be required to investigate further. This may include a mammogram.
These follow-ups can also rule cancer out, as the images could be showing a host of other breast diseases. When abnormalities are present it could be a sign of:
- cancer
- fibrocystic disease
- infection
- vascular disease
A doctor will be able to plan a careful program for further diagnosis and monitoring. They can also identify if treatment is required.
Results categories
After the test, the reports are divided into five categories. These is known as the TH (thermobiological) grading system. The categories are as follows:
- TH-1: Symmetrical, bilateral, nonvascular (non-suspicious, normal study)
- TH-2: Symmetrical, bilateral, vascular (non-suspicious, normal study)
- TH-3: Equivocal (low index of suspicion)
- TH-4: Abnormal (moderate index of suspicion)
- TH-5: Highly abnormal (high index of suspicion)
Follow-up exams are needed at different times for each category, as follows:
- TH-1 and TH-2: every year
- TH-2: every year
- TH-3: every 6 months
- TH-4 and TH-5: every 3 months
These examinations will be carried out in conjunction with other medical examinations and can be done at the doctor's office. People should stay in regular contact with their doctor throughout all these tests and procedures.
Effectiveness
People do not have to decide between breast thermography or mammography, but may use them both. Using the two together can be more effective.
Breast thermography is less effective at detecting small cancers or cancers deeper in the breast tissue.
The use of thermography, mammography, and a clinical exam is known as the "multimodal approach". Using this approach can help identify around 95 percent of early stage cancers.
Technology
A combination of sophisticated infrared cameras and computers are used to conduct thermography.
Thermal imaging technicians capture an infrared photograph, or heat image, of the breast.
This can then be printed in high resolution for a doctor to study, or may be sent to them electronically.
History
Thermography has been experimented with in medical science for many hundreds of years. However, it wasn't until 1972 that the Department of Health, Education and Welfare announced that thermography was "beyond experimental."
This announcement applied to the use of the technology for many areas, including the evaluation of the breast. The advance in technology since then has seen thermography become recognized in multiple areas of medicine, including breast health.
Heat patterns
The cameras used in breast thermography produce ultra-sensitive, high-resolution infrared images. These images show heat patterns and identify changes in the temperature of the skin and blood flow.
Many other technologies that test for breast cancer work in other ways that do not involve looking for heat patterns. These tests include:
- mammography
- ultrasound
- MRI scans
- X-rays
Breast thermal risk index
Other factors can affect the results of a breast thermography. So, often doctors will use the Breast Thermal Risk Index to help ensure more accurate results. This includes:
- age of person
- family history of breast cancer
- medication, including birth control and hormone pills
- menopause
- if the person is overweight
Benefits
Thermography offers the opportunity for early detection of breast cancer and has a number of specific benefits.
Earliest possible detection
A thermograph enables cancer to be detected sooner than other procedures.
Compared with other procedures being used on their own, thermography makes it possible for cancer or pre-cancerous growth to be detected up to 10 years sooner than they may otherwise have been.
Close monitoring
Thermography means that people at potential risk of developing breast cancer can be monitored closely.
Outlook
If breast cancer is caught at an early stage through the use of thermographs, this increases a person's treatment options and should ultimately lead to a more positive outlook.
However, breast thermography only has the potential to identify early warning signs. It cannot diagnose breast cancer on its own, but it may point to potential signs of a problem.
Comparing mammography and thermography.
Breast cancer screening is used to identify breast cancer in women who have no physical symptoms. It is hoped that finding breast cancer early will enable women to undergo less invasive treatments, with better outcomes.
However, there is currently much debate about which methods should be used for screening, and how often women should be screened. At present, the most commonly recommended screening method is mammography.
During a mammogram, the breast is compressed between two plates and an X-ray is transmitted through the breast tissue.
The images that are captured are called mammograms.
Some breasts have dense tissue that appears white on the image film. This can mask the presence of tumors, which also appear white on film.
Other breasts are made up of low density fatty tissue, which appears grey on the image film. It is much easier to see white tumors or calcium buildups on these mammograms.
Benefits
Some evidence suggests that mammography screening is associated with a reduction in the number of women who will die from breast cancer.
However, different groups interpret the data in different ways. Some experts say that screening provides no benefit while others say that it does.
Those who say it does estimate that over the next 10 years, for every 10,000 women who get regular mammograms, the number of women whose lives will be saved thanks to the mammogram is approximately:
- 5 out of 10,000 women aged 40 to 49 years
- 10 out of 10,000 women aged 50 to 59 years
- 42 out of 10,000 women aged 60 to 69 years
The benefit of a mammogram is greater for women in high-risk groups, such as older women, or women with a history of breast cancer in the family.
The United States Preventive Services Task Force (USPSTF) recommend that only women aged 50 to 74 years undergo a screening mammogram every 2 years. Other organizations have different recommendations, as mentioned below.
Potential risks
There are some potential risks that are considered to be associated with mammography and mammograms. They include the following:
- They require repeated exposure to radiation, which may cause a very small risk of cancer if used over a lifetime.
- They can lead to non-invasive cancers being diagnosed and treated when treatment is not necessarily required.
- They are not as effective for women with dense breast tissue or breast implants.
- They can lead to women choosing double mastectomies as a preventive measure.
They have a high rate of false-positive results, which can result in unnecessary biopsies and additional screening. False-positive results are those that suggest that cancer is present when it is not.
In 2009, the USPSTF revised their 2002 suggestion of a mammogram every 1-2 years for women of 40 years and over. One of the reasons for this change was a number of studies that showed an increased risk of false-positive results when screening starts at a younger age or takes place every year.
The USPSTF now recommend that only women aged 50 to 74 years undergo a screening mammogram every 2 years. Although this advice is in line with that offered in many European countries, it differs with the recommendations of some other U.S. organizations.
The American College of Radiology and the Society of Breast Imaging both continue to recommend annual mammograms for women starting at age 40. The current guidelines issued by the American Cancer Society advise a mammogram every year for women of 45 to 54 years, and every 2 years for women of 55 years and older.
As has been shown, the heated debate concerning safe mammography policy and practice continues. In light of the debate, various emerging technologies are now being suggested as alternative options for breast cancer screening.
What is thermography?
Thermography is a test that detects and records temperature changes on the surface of the skin.
Digital infrared thermal imaging (DITI), a type of thermography used in the screening of breast cancer, uses an infrared thermal camera to take a picture of the areas of different temperature in the breasts. The camera displays these patterns as a sort of heat map.
The presence of a cancerous growth is associated with the excessive formation of blood vessels and inflammation in the breast tissue. These show up on the infrared image as areas with a higher skin temperature.
Benefits
It is a non-invasive, non-contact procedure, which does not compress the breast.
It does not involve exposure to radiation, and so it can be used safely over time.
It can detect vascular changes in breast tissue associated with breast cancer many years in advance of other methods of screening.
It can be used for all women, including those with dense breast tissue and breast implants.
Hormonal changes do not affect results.
Drawbacks
It has a high false-positive rate, which can result in the woman having to have the standard mammogram anyway.
It has a high false-negative rate, which can lead to avoidance of the standard mammogram as a woman may feel she has been adequately screened.
It is rarely covered by medical insurance.
A false-negative result is one that suggests that cancer is not present when it is. It is important to stress the high levels of false-positive and false-negative rates, as there are other screening options available.
Sursa: https://www.medicalnewstoday.com/articles/316632.php
