Medical Thermology
As a committed health care provider, you have probably been introduced to medical thermography or thermology at one point in your career. Today, thermology is becoming widely accepted as one of the more sensitive and objective tools for medical assessment and diagnostics.
Thermology: A Definition
Thermology is the medical science that derives diagnostic indications from highly detailed and sensitive infrared images of the human body. Thermology is sometimes referred to as digital infrared imaging or tele-thermology and utilizes highly resolute and sensitive infrared (thermographic) cameras. Thermology is completely non-contact and involves no form of energy imparted onto or into the body. Thermology has recognized applications in breast oncology, chiropractic, dentistry, neurology, orthopedics, occupational medicine, pain management, vascular medicine/cardiology and veterinary medicine.
Thermology: The History
The aura of modern thermology's cutting-edge technology obscures its venerated origins as one of Hippocrates' cardinal signs of pathology: Calor (heat). In 400 BC, Hippocrates wrote, "In whatever part of the body excess of heat or cold is felt, the disease is there to be discovered". The ancient Greek physicians of the Golden Age were known to employ a primitive form of thermology as they would apply thin mud slurry onto areas of their patient's bodies to observe the patterns and rates of drying. Modern thermology has been refined into a proper, albeit a young science with a venerated history. The first electronic infrared sensors were developed in the 1950's for military intelligence and then were provided for medicine. The early thermographers of the modern era were accomplished and comprehensive experts in their respective fields of breast oncology, vascular medicine or neurology. These pioneering thermographers worked in specialty centers with a multi-modality approach to diagnostic medicine. They discovered that the thermograms of women with malignant breast tumors characteristically presented abnormal and high-energy blood vessels approximating the tumor. However, it was not until 1971 when Judah Folkman formalized the theory of neo-angiogenesis that the nature of these abnormal blood vessels became explained.
Thermology: The Principles
The inherent inefficiencies of metabolism are the source of body heat. This heat must be transferred to the environment or its accumulation will increase body temperature, cause the destructive denaturizing of body proteins and ultimately death. At comfortable room temperatures, the principle means of body heat loss to the environment is emission of infrared energy from the skin. Human skin, irrespective of its pigmentation, is an almost perfectly efficient emitter of infrared energy; meaning that the intensity of infrared energy occurs in direct proportion to skin temperature. The emission of infrared energy from the skin is quite superficial and skin temperature is principally affected by small-caliber vascular perfusion. Skin perfusion is in turn modulated by the autonomic nervous system as a means of maintaining a closely regulated core body temperature. However, the metabolic activities of underlying tissues will also affect skin temperature. Thermal energy from these tissues will "float" to the skin surface and present an infrared "character" that is distinctive for each anatomic site.
The development of new blood vessels (angiogenesis) of a solid malignant tumor must occur when it has grown too large for simple diffusion from existing blood vessels to provide for the metabolic needs of the cells at the center of the tumor. The process of angiogenesis begins when a malignant tumor is about 150 micrometers (0.15mm) in diameter and must be extensively developed by the time a tumor is 1-2 mm in diameter. Angiogenic blood vessels are unstable and do not have the ordered structure of normal blood vessels. In fact, angiogenic vessels are of a primitive structure without any connection to the autonomic nervous system and no vascular smooth muscle content. Nitric oxide is produced by metaplasia and malignant tissue with the effect of potent regional vasodilatation. Thermology is able to characterize malignant breast disease by indicating the unregulated hyper-perfusion of these defective blood vessels and resulting convection of core-temperature thermal energy to the region of the disease. This means the defective blood vessels of malignant disease can be characterized during an intentional challenge procedure to the autonomic nervous system by their inability to constrict as contrasted from normal blood vessels that will constrict. In fact, our experience demonstrates that breast cancer-related blood vessels may actually increase their caliber and temperature subsequent to the autonomic challenge procedure, probably from shunting.
High-sensitivity digital radiometric focal plane infrared cameras are coupled with powerful computers and sophisticated software to enable a quantum step as a diagnostic technique in functional medicine. Thermology interpretative standards necessarily involve a quantitative analysis of the data. Thermology has established diagnostic effectiveness in rheumatology, neurology, physiotherapy, sports medicine, orthopedics, pediatrics as well as oncology. Furthermore, the high sensitivity of thermology often makes an invaluable monitor of the effectiveness of patient treatment programs.
Thermology: The Technique
The practical application of this challenge procedure involves placing a woman's hands into a basin of cold (approximately 11 degrees C) water for one minute between two sets of identically positioned images. The cold water acts as an intentional challenge to the autonomic nervous system. The expected response to this challenge is a vaso-constrictive effect that will be uniform throughout the woman's breasts and symmetrical. The pre- and post-challenge images can be compared in order to determine a temperature decrease that should occur as a result of the decrease in the caliber of normal blood vessels. This technique, then, contrasts the normal and reactive blood vessels from the non-responding blood vessels that are an important means of characterizing the angiogenic and nitric oxide-dilated blood vessels. Other techniques that blow cold air or spray cold water or alcohol onto a woman's breasts produce significant and complicated artifact rather than a physiologic challenge. We consider these techniques as unsound. It is our experience that the autonomic challenge procedure diminishes the number of false-positive errors by indicating non-cancerous inflammation or mastitis as a basis for atypical high-energy blood vessels. The autonomic challenge procedure also diminishes the number of false-negative errors by contrasting non-modulating blood vessels from other prominent blood vessels in the same or contralateral breast.