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Microwave Thermography
RTM – Principles
The RTM-01-RES radiometer receives and evaluates the
natural electromagnetic radiation (temperature) from the
patient’s internal tissues at microwave
The Volume Under Investigation
Skin
Internal Tissues
Microwave Sensor
Antenna
P=k T ΔF
K-Bolzmann coefficient
ΔF-the receivers bandwidth
The Volume Under
Investigation
Microwave Penetration Depth in Human Tissue
Temperature and Blood flow Patterns in breast
cancer (M. Gautherie 1982)
85000 patients have been examined in three
Breast Centers in France during 17 years.
• Departement de Senologie, Hospices Civils
• Unite de Senologie, Hospital de Hautepierre
• Centre de Senologie
The distribution of temperature and thermal
conductivity in cancerous and healthy breast
Metabolic heat production as a function of
doubling time of tumor volume
70
Metabolic heat
production,
60
( мWt/cm3 )
50
40
30
Without lymph
node
metastases
With lymph
node
metastases
20
10
0
100
200
300
400
500
600
Doubling time of tumor volume (days)
700
M. Gautherie monitoring of 1245 women
with Th III increase of hyperthermia
during 12 years
784 patients without benign lesions
461 patients with benign mastopathy
Evolution of cancer for the patients with
benign mastopathy and
stable Th III increase of hyperthermia
% 50
40 The percentage of Breast
Cancer cases
30
20
The number of patients – 461
10
0
0
2
4
Years
6
8
% 40
Evolution of cancer for the patients without
benign lesions and stable Th III increase of
hyperthermia
The percentage of
Breast Cancer cases
35
30
25
20
15
10
5
0
The number of patients– 784
0
2
4
Years
6
8
The Internal Temperature Difference
as a Function of Microvessel Density (MVD)
T. Yahara, 2003
Internal Temperature Difference
Microvessel Density (MVD)
Angiogenesis of Breast Cancer
• Angiogenesis, the process of new blood
vessel formation, play the central role in
both local tumor growth and distant
metastasis in breast cancer.
• Angiogenesis precedes transformation of
mammary hyperplasia to malignancy
B. P. Schneider, 2005
Tumor Angiogenesis: A New Significant and Independent
Prognostic Indicator in Early-Stage Breast Carcinoma,
( Weidner,1992)
• Microvessel density was the only statistically significant
predictor of overall survival among node-negative
women. Only microvessel density and histologic grade
showed statistically significant correlations with
relapse-free survival in the node-negative subset
• Conclusions: microvessel density in the area of the most
intense neovascularization in invasive breast carcinoma
is an independent and highly significant prognostic
indicator for overall and relapse-free survival in
patients with early-stage breast carcinoma (I or II by
International Union Against Cancer criteria)
Microvascular density in preinvasive lesions
of the human breast
Viakava P., Naccarato AG., 2004
Types of pre-invasive lessions
Abbreviation
MVD
Normal
115
PDIC
190
IDIC
167
Well- differentiated intraductal carcinoma
WDIC
125
Lobular cancer in situ
LCIS
168
Atypical lobular hyperplasia
ALH
125
Atypical ductal hyperplasia
ADH
122
FD HUT
123
Normal
Poorly differentiated intraductal
carcinoma
Intermediately differentiated intraductal
carcinoma
Florid ductal hyperplasia of usual type
Vascular score for different
breast disease (Heffelfinger, 1996)
RTM – 01 – RES
Imaging System
Items
Thermal abnormality (i.e. a lower or
higher temperature) is detected at a
depth of, cm
Specifications
2 -5 (depending
on water content
tissue type)
Accuracy of measuring the averaged
internal temperature, when a
temperature is 32 - 38 C, C
 0,2
Time required for measuring internal
temperature at a point, seconds
6
Antenna diameter, mm
Accuracy of measuring the skin
temperature, C
39
 0,2
Time required for measuring skin
temperature at a point, when the
temperature is 32 - 38 C, seconds
1
Device mass, kg
4
Power consumption, Watt
5
RTM - Diagnosis
The temperature is measured in 9 points of each breast
and in two reference points
RTM-Diagnosis Software
Data of the measured temperatures are automatically stored in the
computers memory to be processed.
Healthy Woman’s Field
Right MG
Isotherm step
Temperature(ºC): Minimum 34.8,
Mean 35.1,
Left MG
Maximum 35.4
Thermogram of internal and skin
temperature for normal breast
Breast Temperature Field
Right MG
Isotherm step
Temperature(ºC): Minimum 32.8,
Mean 33.8,
Left MG
Maximum 35.3
Breast Cancer internal temperature field
Breast cancer thermogram of internal
and skin temperature
Before the treatment
• The RTM-01-RES is
indispensable for the
Right Breast
Left Breast
monitoring of treatment due
to the fact that it is
absolutely harmless.
After the treatment
Right Breast
• This is a sample of the
positive dynamics which
occur during the treatment of
mastitis.
Left Breast
The clinical trials of RTM -01-RES
The total number of patients is 1207
The breast cancer patients -271
№
The place of the clinical trials
Year
Sensitivity,%
Specificity,%
1
Oncological Hisoital # 40,
Moscow, Russia
1997
94.2
71.4
2
Mammological dispensary
Moscow, Russia
1998
85.1
76.5
3
Ontological centre
Moscow, Russia
1998
89.6
81.8
4
Maim military Hospital
(Burdenko)
Moscow, Russia
2001
98
76
5
Mammological dispensary
Moscow, Russia
2002
95
57
6
Medical College, Arkanzas, USA
2003
85
70
7
Russian Scientific Center for
X-ray-radiology, Moscow, Russia
2006
96.6
56.6
Russian Scientific Center for X-ray-radiology,
Moscow, Russia, 2006
The main tasks of the clinical trials were:
• To estimate the level of temperature changes for
tumors with different degree of malignancy
• To estimate the correlation between RTM results
and color Doppler ultrasonography results
• To estimate the sensitivity and specificity of RTM
method for breast cancer detection
Method and Materials
•
•
•
•
•
•
•
•
Clinical examination
Mammography
Ultrasonography
Doppler ultrasonography
Mamma stintigraphy examination
RTM method
Biopsy
Histology
The subjects of study
Pathological changes
Number
1 Ductal hyperplasia
23
2 Fibroadenoma
11
3 Atypical proliferation
15
4 Breast cancer
30
5 Total
79
Breast cancer types
Type of cancer
Non invasive cancer
В том числе:
Introductal cancer in situ
Lobular cancer
in situ
Infiltrative ductal cancer
Infiltrative lobular cancer
Another types of cancer
Total
Number
6
%
20
5
1
15
2
7
17
3
50
7
23
30
100
The evaluation of the thermal changes
The thermograms were characterized by Th parameters.
The maximum index is Th5, the minimum – Th0.
No.
Index
Degree of expression of thermal changes
1
Th0
Practically no thermal changes
2
Th1
Decreased thermal activity of tissues
3
Th2
Insignificant thermal changes
4
Th3
Heightened thermal activity without local hotbed
and without high thermal asymmetry
5
Th4
High level of thermal activity, with the presence of
hotbed asymmetry without local increases of
temperature
6
Th5
High level of thermal activity, with the presence of
hotbed asymmetry and with the presence of local
increases of temperature
Temperature changes for tumor with high
degree of malignancy
% 90
80
70
High degree of
malignancy
60
50
40
30
20
10
0
Th2
Th3
Th4
Th5
Temperature changes for tumor with
intermediate degree of malignancy
% 70
60
Intermediate degree of
malignancy
50
40
30
20
10
0
Th2
Th3
Th4
Th5
Temperature changes for tumor with low degree
of malignancy
% 50
Low degree of
malignancy
45
40
35
30
25
20
15
10
5
0
Th2
Th3
Th4
Th5
The sensitivity of different methods for breast
cancer detection
№
The type of
examination
Sensitivity %
False negative
results %
1
Clinical
examination
76.7
23.3
2
Ultra
sonography
76.7
23.3
3
Doppler Ultra
sonography
Mammastintig
raphy
80.8
19.2
84.0
16.0
96.6
3.4
4
5
RTM method
The sensitivity of different methods
for cancer in situ detection
The type of
examination
Sensitivity
%
False negative
results %
34
66
№
1
Clinical examination
2
Ultrasonography
34
66
3
Doppler Ultra
sonography
0
100
4
Mamma-scintigraphy
75
25
5
RTM method
83
17
Conclusion:
• In 90% of breast cancer patients have significant thermal
changes.
• 80% patient with breast cancer in situ have thermal changes
captured with the RTM-01-RES.
• In 50% of cancer in situ cases are accompanied by very
strong thermal changes (Th5).
• 80% of patients with the atypical hyperplasia have thermal
changes of mammary glands
• At the high degree of malignance predominate the maximal
thermal changes (Th5), at the intermediate degree of
malignance predominates the Th4 thermal changes, at the low
degree of malignance over half of the patients have the index
Th3 and Th2.
• The RTM method allows to identify patients having high risk
of malignization and needing further examination.
Conclusion
RTM method is very promising method for
to identify patients with the increase risk of
breast cancer. Combination RTM method and
mammography increase sensitivity of breast
cancer diagnosis to 98%