- Thermography FAQs
- Articles About Thermography
- 1. Are All Thermographers Created Equal?
We currently use the Mikron Thermographic equipment which was the first equipment built for medical application is still one of the best. Most other cameras are built for industrial application and modified for medical uses. Because medical thermography needs to be replicated, some other systems have not been able to control the “drift” factor. This allows for too much inconsistency.
The American Academy of Thermology has established these nationally and internationally accepted guidelines for breast thermography which call for two sets of eight images each, taken in black and white and color with a cold challenge between sets. Thyroid/dental and neuromuscular studies vary in the number of images taken. It is imperative, however, that the interpreting physician measure and mark contralateral regions of interest on the actual images for maximal accuracy and future comparative purposes. These markings lead to provide finite calculations to 0.1 degree centigrade allowing for the most accurate interpretation of possible abnormalities.
It is important that the study be done under the controlled conditions established by the international thermographic community. These include room temperature controls, reduction of ambient light, and careful monitoring of air flow. The images should be taken by a trained, certified technician and interpreted by a certified, licensed health care practitioner. Additionally, we strongly believe there needs to be a line of communication between the patient and the doctor reading the thermogram. To that end, we offer a fifteen-minute phone conference between Dr. Getson and the patient to review the findings, answer any of the patient’s questions, and provide guidance (upon request). We have found it very beneficial to encourage patients to be part of the process and foster a level of understanding and education. Our comprehensive program allows patients to feel confident, comfortable, and supported in their decision to make Thermography a part of their breast health program.
- 2. How Can I Learn More About Thermography?
In addition to the information on our website, Dr. Getson is available to speak to your group or association. Please contact the office at (856) 596-5834 for more information or to schedule a lecture.
- 3. How Do I Understand My Thermographic Report?
Color Thermography is based upon the scientific evidence that the body is symmetrical unto itself. We realize that NO ONE is completely symmetrical in terms of size, shape, or temperature. For that reason, the thermographic community has established criteria that allow up to 1.5 degrees C from one side of the body to the other and still consider it to be normal. The only exception is at the nipples where the maximum limit of normal is 1.0 degrees C.
As the patient faces the camera for the images to be taken, what is seen on the left side of the image is on the right side of the body (in those images where both breasts are present on the same frame).
The circles or other markings that are seen on the pictures are drawn by Dr. Getson and the data beneath each picture is calculated by the computer. The most important information on the data table is the second line, “average” which is the average temperature within the circle on the picture above.
When viewing the black and white images, circles are placed around blood vessels to highlight their presence. Having blood vessels is not necessarily abnormal, as the presence of vessels can result from aging, trauma to the breast, hormonal influences, and other causes. Once present these vessels will be evident forever. Trauma can occur in many forms such as seatbelt impact from a car accident, other types of contact injury, and even mammograms. Some blood vessel configurations, however, are worrisome and these will be discussed at the time of the phone conference.
Following is a definition of some thermographic terms:
- VASCULAR COMPLETE: An uninterrupted blood vessel usually of two inches or more in length.
- FRAGMENTED VASCULAR ANARCHY: Bits and pieces of a blood vessel.
- INFERIOR VESSEL: A heat generating vessel that lies below the horizontal plane of the nipple.
- HOT SPOT: A solitary area of heat in one breast exceeding 1.5 degrees C.
- GLOBAL HEAT: A generalized area of heat exceeding 1.5 degrees C.
- PERIAREOLAR HEAT: Heat in excess of 1.5 degrees C in the area surrounding the nipple.
- 4. Is Thermography an Approved Procedure?
Yes, it was approved by the FDA in 1982. Also in 1984, the American Medical Association certified thermography as being “beyond the experimental and investigational stage.”
- 5. Is Thermography Costly?
Our fee for breast Thermography is $300.00. Within two weeks after the study, the patient will receive a packet. The packet will include two sets of nine images each, one set in color and one set in black and white. A comprehensive report by Dr. Getson and a universal claim form will also be included. A copy of the report is provided to the clinician(s) of your choice. When applicable, a fifteen-minute phone conference with Dr. Getson is provided at no additional cost.
The cost for a thyroid/dental thermogram is $125.00. This study consists of nine images which are a mixture of color and black and white images, Dr. Getson’s report, a universal claim form and when necessary a follow-up 15-minute phone conference with Dr. Getson is included. A copy of the report is provided to the clinician(s) of your choice.
When coupling a thyroid/dental study with a breast thermogram a $25.00 discount is applied.
We encourage everyone doing a Breast Thermogram to do at least one Thyroid/Dental study as a dental infection left untreated by a biological/holistic dentist can result in systemic infection. Based on dental/organ charts there are eight teeth connected to the mammary glands.
The cost of a neuromuscular thermogram depends upon the complexity of the study. Neuromuscular Thermograms are recommended for individuals suspected of having or diagnosed with Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome, Fibromyalgia, or any other undiagnosed neuromuscular condition. Please call the office for more information regarding this study.
- 6. Is Thermography Covered by Insurance?
Payment is required at the time of service. For reimbursement purposes, each patient is provided with a universal claim form which includes CPT and ICD-10 codes for them to submit to insurer for reimbursement. This claim form will arrive in the mail along with the patient’s results within two weeks of the date of their thermogram. In the case of breast thermography, we have found that the insurers are more likely to reimburse individuals with dense breasts, scarring from prior surgery, history of breast disease – be it themselves or a family member (particularly in women under 40 years of age) – breast implants, neuropathic pain and for women with inconclusive anatomic studies. In these instances, a physician’s prescription may be helpful in facilitating reimbursement but is not necessary.
- 7. My Doctor Doesn’t Know Much About Thermography
My doctor does not know much about thermography and isn’t sure it is a valid diagnostic tool. How should I respond to this?
- The camera is FDA cleared.
- The American Medical Association (AMA) approved thermography as an adjunctive test for the diagnosis of breast disease in 1982.
- In 1984 the AMA certified that thermography was “beyond the experimental and investigational stages.”
- Over the last ten years, there have been great technological advances in thermal imaging cameras and their accompanying computer software.
- Medical thermography has been available for over 60 years, predating mammography by a decade.
There is confusion surrounding thermography due in part to the fact that, in 1983, thermography was inappropriately placed in a DATTA study. The Diagnostic and Therapeutic Technology Assessment program (DATTA) was established by the AMA to provide accurate, balanced, and up-to-date information on medical technology to the practicing medical community. Once the study on thermography was completed, it was apparent that it had serious flaws. Many of the testing sites were mobile trailers without any temperature or environmental controls. In a diagnostic test that depends primarily on temperature measurement, this was an inexcusable omission. Next, the “technicians” who performed the studies had little or no training. Finally, the interpreters were radiologists who had no expertise in the interpretation of thermal images, many of whom were operating under the misguided premise that the evaluation of a thermogram was “simple.” Moreover, it was not until the 1980s that the thermographic community established standard protocols and formal training.
How then, could the study with all of its inherent flaws have stood a chance of accurately evaluating thermography? And yet to this day, critics of thermography still rely on this forty-year-old study while choosing to ignore the monumental advances in thermal imaging.
The use of thermography in the diagnosis of neuropathic pain is clearly explained by reading Dr. Getson’s article titled “The Use of Thermography in the Diagnosis of CRPS: A Physician’s Opinion”. Click here to read this article.
- 8. Should I Have a Mammogram?
This is an individual decision which must be made by each patient. Due to the high number of false negatives inherent in mammograms, it is becoming increasingly apparent that no one diagnostic test is sufficient for the assessment of breast disease. Mammographers acknowledge a 15% to 20% false negative rate, a number made higher by women with dense breasts, implants, and scar tissue. Due to the fact that thermography is a physiologic study and the results are not affected by these anatomic issues, additional information can be provided which is not readily available on a mammogram. Further, it has been shown that a positive (abnormal) infra-red image is the single most important marker of increased risk for the development of breast cancer.1
- 9. What About Ultrasound and MRI?
Anatomic testing such as Mammography, Ultrasound, MRI, and CT Scanning do not provide skin vascular and metabolic information offered by Thermal Imaging. The clinical application of Thermography can help physicians understand physiology and potential pathology thereby improving patient outcomes.
We have found that the addition of Ultrasound to Thermography has been very useful. Because thermography can often localize an abnormality often to one quadrant of the breast, we are able to provide the ultrasound technician with a “road map” so that the study can be concentrated in a small area thereby increasing the effectiveness of this test.
With the increased usage of MRI’s, there has been a natural segue between these two tests. The MRI has provided a “large screen” view of the breasts which when coupled with thermographic imaging has been found to be extremely effective in diagnosing breast disease. Breast MRIs use a contrast dye called Gadolinium which is water-soluble and excreted in the urine within 24 hours. In healthy individuals there have been very limited side effects to this drug.
Both of these studies have the added advantage of providing information without the use of radiation.
- 10. What is the procedure for a Breast Thermogram?
Breast thermography or infrared imaging is a physiologic study that can measure changes in breast tissue by providing reproducible and accurate images of skin temperature. These images can be analyzed both qualitatively for thermovascular mapping and quantitatively for minute changes in skin heat emission. Anatomic findings may not correlate exactly and may not even be evident as Thermography, being a physiologic study may display abnormalities years before anatomic changes are seen.
The room is maintained at 68-70 degrees, the ideal temperature for thermographic testing. The patient disrobes from the waist up. The patient then equilibrates to the room temperature for ten to fifteen minutes. The patient is standing about 3 feet from the camera with her arms resting on top of her head. There is no physical contact, no compression, or radiation. Two sets of nine thermographic images are taken by a female technician. After the first set of images is taken, the patient is asked to hold an ice pack for one minute. In Thermography this is called a thermoregulatory challenge. The cold challenge provides additional information by determining whether blood vessels dilate or not, allowing us to better define suspicious vessels in the black and white views. The second set of images is taken, the patient dresses, and departs. Usual time spent in the office is 30 minutes.
- 11. What is the procedure for a Neuromuscular Thermogram?
Thermography or infrared imaging is a physiologic study that can measure changes in tissue by providing reproducible and accurate images of skin temperature. These images can be analyzed both qualitatively for thermovascular mapping and quantitatively for minute changes in skin heat emission. Anatomic findings may not correlate exactly and may not even be evident as Thermography, being a physiologic study may display abnormalities years before anatomic changes are seen.
Infrared Imaging is the only non-invasive technology available to image and map vasomotor instability. It can play an important role in clinical diagnosis and may be helpful distinguishing between central and peripheral changes affecting the sympathetic nervous system.
Other technologies like MRI, Ultrasonography, CAT Scans, and Electrodiagnostics or EMG do not provide the same information offered by Infrared Imaging. The clinical application of Infrared Imaging may be important in understanding the pathophysiology associated with these changes and improve patient outcomes.
Infrared neuromusculoskeletal imaging provides an overview of the location, extent, and severity of sympathetic skin response abnormalities. When abnormalities due to vasomotor/sudomotor dysfunction occur there are associated changes in skin temperature. Infrared Imaging can be performed from the cervical through the lumbosacral spine and includes the upper and lower extremities, inclusive of the fingers and toes.
The room is maintained at 68-70 degrees, the ideal temperature for thermographic testing. The patient disrobes to their undergarments. We provide disposable undergarments for men and women. If you prefer to wear your own we ask women to wear a thong and our disposable bra and men are asked to wear an athletic supporter or bikini briefs. This level of exposure is necessary in order for us to image the buttocks which are an integral part of the study. The patient then equilibrates to the room temperature for ten to fifteen minutes. The patient is standing about three feet from the camera. There is no physical contact, no compression, or radiation. Usual time spent in the office varies between thirty and sixty minutes depending upon the complexity of the study.
- 12. What is the procedure for a Thyroid/Dental Thermogram?
Thermography or infrared imaging is a physiologic study that can measure changes in tissue by providing reproducible and accurate images of skin temperature. These images can be analyzed both qualitatively for thermovascular mapping and quantitatively for minute changes in skin heat emission. Anatomic findings may not correlate exactly and may not even be evident as Thermography, being a physiologic study may display abnormalities years before anatomic changes are seen. The room is maintained at 68-70 degrees, the ideal temperature for thermographic testing. We encourage attire that exposes the patient’s entire neck or they may be asked to remove their shirt only. The patient equilibrates to the room temperature for ten to fifteen minutes. The patients is standing about three feet from the camera or sitting on a stool. There is no physical contact, nop compression, or radiation. Nine images are then taken of the face and neck. Usual time spent in the office is twenty minutes
Infrared imaging can be an important part of the overall assessment of Thyroid/Dental disorders as well as certain systemic health-related illnesses. It can also be useful in monitoring treatment dental, thyroid, and other related systemic health conditions.
Other structural imaging technologies such as X-Ray, Ultrasound, CT, and MRI, do not provide the information offered by Thyroid/Dental Thermography. The addition of Thermography can, therefore, help improve diagnosis and clinical outcomes.
- 13. When Will I Get My Report?
A copy of the images, a written report of the findings, and a universal claim form will be sent to the patient within 14 days of the study. A copy of the report will be sent to the patient’s healthcare professional(s) upon request.
- 14. Who Is Qualified to Take and Interpret Thermographic Images?
The performance of thermographic imaging should only be done by a Board Certified or Board Eligible technician. The interpretation of these images must be done by a licensed health care provider (D.O., M.D., D.C.) who has been certified by a recognized thermographic organization. These clinicians are the only ones trained to interpret and apply the information garnered from the thermogram.
- 1. About Breast Thermography
By: Philip Getson, DO & Liesha Getson, CTT
The American Cancer Society's (ACS) statistics on breast cancer are shocking Every three minutes, in the United States alone, another woman is diagnosed with this dreaded disease, which annually claims the lives of more than 40,000 women.
With the incidences of breast cancer on the rise, and prevention now considered more valuable than cure, women are beginning to educate themselves on the option of including a thermogram in their annual checkup. This little known tool for risk assessment measures thermal emissions emanating from the body, a key indicator of health. Available here in the U.S, since the 1960's, it was approved in 1982 as an adjunct to mammography...
- 2. Breast Screenings: Data and Decisions 101
This is an excerpt of an article in 4Wholeness.com
Another way to produce images of the breast for study is by using thermography — a form of infrared imaging that produces a picture of the breast that maps temperature variations. On his website, Dr. Philip Getson describes this technology: "Medical thermography uses infrared technology to provide an image of the body's physiological responses. By detecting thermal asymmetry or by noting alterations of the vascular patterns, the physician now has more information with which to make an assessment of breast, neurological and other conditions." Certified Clinical Thermographer Catherine Johnson further explained that such imaging shows temperature differences that can correlate with various types of abnormalities, of which malignancy could be one...
Dr. Getson explained that while a mammogram study shows us how the breast looks, the thermogram creates a picture of the way it works. He describes thermography as a "breast health risk assessment tool."...
As with mammography, ask about the credentials of both who performs the test and who reads it. Dr. Getson emphasized that the test should be performed by a board certified or board eligible technician and it should be interpreted by a licensed health care provider...
- 3. Breast Thermography: Can It Open a Window for Breast Cancer Prevention?
by: Erik L. Goldman
Ifs radiation-free, non-invasive, FDA-approved, relatively inexpensive, and detects early, potentially reversible physiological changes associated with later development of breast cancer. So, why isn't breast thermography a routine part of women's health practice?
If really ought to be, say a growing number of physicians who are re-discovering this long-overlooked imaging method. Advocates say it's a technology whose time has come, not so much as a substitute for mammography, but as a method of identifying tissue which tumors are more likely to emerge...
- 4. Effectiveness of a Noninvasive Digital Infrared Thermal Imaging System in the Detection of Breast Cancer
Digital infrared thermal imaging (DITI) is a noninvasive, non-contact system of recording body temperature by measuring infrared radiation emitted by the body surface. This technology was originally designed for US military use in night vision but also has many applications in medicine. Its use in the field of medical oncology lies in the fact that tumors generally have an increase in blood supply and angiogenesis, as well as an increased metabolic rate, which in turn translates into increased temperature gradients compared to surrounding normal tissue. Detecting these infrared "hotspots" and gradients can thereby help to identify and diagnose malignancy.
- 5. IACT A Review of Breast Thermolgraphy
By William C. Amalu, DC, DIACT (B), FIACT
The first recorded use of thermobiological diagnostics can be found in the writings of Hippocrates around 480 B.C.. A mud slurry spread over the patient was observed for areas that would dry first and was thought to indicate underlying organ pathology. Since this time, continued research and clinical observations proved that certain temperatures related to the human body were indeed indicative of normal and abnormal physiologic processes. In the 1950's, military research into infrared monitoring systems for night time troop movements ushered in a new era in thermal diagnostics. The first use of diagnostic thermography came in 1957 when R. Lawson discovered that the skin temperature over a cancer in the breast was higher than that of normal tissue.
- 6. The Best Breast Test: The Promise of Thermography
By: Christiane Northrup, MD
Every year when Breast Cancer Awareness Month (October) comes around I am saddened and surprised that thermography hasn't become more popular. Part of this is my mindset. I'd rather focus on breast health and ways to prevent breast cancer at the cellular level than put the emphasis on testing and retesting until you finally do find something to poke, prod, cut out, or radiate. I understand that mammography has been the gold standard for years. Doctors are the most familiar with this test, and many believe that a mammogram is the best test for detecting breast cancer early. But it's not. Studies show that a thermogram identifies precancerous or cancerous cells earlier, produces unambiguous results (which cuts down on additional testing), and doesn't hurt the body. Isn't this what women really want?...
- 7. Thermography: A preventive screening tool for breast health
By Erika Horowitz, ND, MSOM
Breast cancer is the second-leading cause of death among women, behind lung cancer. According to the American Cancer Association, in 2007 an estimated 178,480 new cases of invasive breast cancer will be diagnosed among women, as well as an estimated 62,030 additional cases of in situ breast cancer. In addition, approximately 40,460 women are expected to have died from breast cancer in 2007 (American Cancer Association, n.d.). Epidemiological studies estimate that one in eight women will develop breast cancer during their lifetimes.
Moreover, one in five women with breast cancer will die of the disease, despite the considerable advances in treatment (Keyserlingk, 1998). Given these circumstances, early detection of breast cancer is considered an important prognostic factor. There is general consensus that earlier detection of breast cancer can improve survival rates, resulting in a 30%-40% reduction in deaths from breast cancer within 10 years from detection (Roebuck, 1986). Adoption of screening programs has been based on the premise that early detection leads to early treatment, which leads to better survival rates...