Dynamic angiothermography
Dynamic angiothermography (DATG) is a technique for the diagnosis of
Angiothermography is not a test that substitutes for other tests, but stands in relation to them as a technique that gives additional information to clarify the clinical picture and improve the quality of diagnosis.
History
In the early 1970s, studies of Professor J. Tricoire in France focused on the application of
During the time at which contact thermography screening was being practiced, more detailed studies on the change in the breast due to the presence of tumors and lesions were being performed. The connection between breast tumors and vascularization was highlighted and studied in detail by Judah Folkman in his research on angiogenesis which began in 1965. These studies, the more complete description of this process, and the models emergent from this work, earned Folkman the Wolf Prize in Medicine in 1992.
Dynamic angiothermography utilizes
The general idea emerging from several clinical studies is that every woman has their own blood pattern image, which is like a fingerprint and, in healthy women, can remain unchanged over time.[6] Changes in this "fingerprint" are evidence of a suspected tumoral or pre-tumoral activity.
Description
The current state of the equipment, by which this examination is done, consists of two parts, and can be combined into a highly mobile footprint. The first component is the thermographic sensor to be placed on the breast. The second is a connection to a computer that records the acquired images. The sensor records the distribution of blood at temperatures between 30 °C and 35 °C. When the sensor is leaning on the breast, the heat, produced by vascularization, induces an image due to the change of the liquid crystal state that passes from solid (black coloured) to liquid. While in the previous contact thermography the doctor studied the colour distribution, in the new methodology (dynamic angiothermography) the image is inspected for information conveyed about local blood distribution. In a healthy breast, the pattern formed by normal vascularization looks like a pointed image in the direction of the nipple. In the case of a tumor, or even of a precancerous lesion, the pattern appears to have rounded shapes which converge from different areas of the breast to feed the tumor. The images can be interpreted visually by the doctor, and/or evaluated with the aid of digital image enhancement tools. Future possibilities extend to more automated detection using computer-aided inspection. The standard procedure is that the doctor looks examines the patient clinically (with palpation) and then acquires two projections of the right breast (side and front) and two of the left (side and front). Digital photos are also acquired and these results are compared with other pictures previously acquired. In the case of evident superficial veins, the breast must be cooled with a current of cold air.
Comparison with other techniques
Comparative diagnostic exams of reference for the cancer of the breast are
DATG is not a test that directly substitutes for other tests, but stands in relation to them as a technique that provides a detailed and non-invasive look at the changes in blood flow in the breast.[7] As such, it has been most successfully employed in combination with other tests to improve the quality of the diagnosis. Further, it may be the most non-invasive technique possible for performing early screening.
Mammography measures the differences of the tissue density inside the breast with substantial spatial resolution but requires at least a low dose of radiation. In many cases the tumors or lesions are directly imaged with respect to size and shape. Image interpretation for mammograms is mature and can be effective. However, there are concerns that the higher density of breast tissue in patients younger than 40–45 years of age degrades the diagnostic information obtained in this technique. Some studies have shown that mammography is less effective before age 50.[8] It is also difficult to see precancerous lesions with mammography, which have not emerged into localized density changes imaged by the low dose of radiation.
Breast
Dynamic angiothermography (DATG) is a technique that does not require ionizing radiation or toxic contrast agents, can be used on patients of all ages, has good specificity and is able to diagnose even precancerous lesions[5] while it is not able to measure the size of a tumor or lesion.
Advantages and disadvantages
DATG is able to detect changes in blood flow that are indicative of breast cancer, may be used for younger patients, is non-invasive (no need for radiation or contrast agent, no need for compression of the breast) and is lower-cost than alternatives requiring minimal facilities. This technology, performed quickly (5–6 minutes for visit) and very precise, is useful for
By contrast DATG is not able to determine the size of the tumor. Rather, the diagnostic information from DATG indicates the presence of a suspicious lesion and points to the area where to look for it. In fact, the intensity and the size of the features in the image acquired by DATG are not correlated to the shape and size of the tumor but to its underlying biological activity (see angiogenesis described above). Lastly, the interpretation of DATG images can be done either by a radiologist, surgeon, oncologist, gynecologist or simply by a medical professional after explicit training to evaluate the DATG images.
References
- PMID 4792563.
- PMID 1194631.
- PMID 872067.
- ^ Montruccoli GC, Montruccoli Salmi D, Casali F (January–March 2004). "A new type of breast contact thermography plate: a preliminary and qualitative investigation of its potentiality on phantoms". Physica Medica. 20 (1): 27–31. Archived from the original on 2016-08-07. Retrieved 2013-03-19.
- ^ PMID 17914573.
- PMID 5054275.
- PMID 19223370.
- PMID 16136033.
- S2CID 25758608.
- PMID 14686695.
- S2CID 22540643.