Microwave Thermography

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Microwave Thermography
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RTM Principles
The RTM-01-RES radiometer receives and evaluates
the natural electromagnetic radiation
(temperature) from the patients internal tissues
at microwave
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The Volume Under Investigation
Skin
Internal Tissues
Microwave Sensor
The Volume Under Investigation
Antenna
Pk T ?F K-Bolzmann coefficient ?F-the receivers
bandwidth
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Microwave Penetration Depth in Human Tissue
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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

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The distribution of temperature and thermal
conductivity in cancerous and healthy breast
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Metabolic heat production as a function of
doubling time of tumor volume
Metabolic heat production, ( ?Wt/cm3 )
Without lymph node metastases
With lymph node metastases
Doubling time of tumor volume (days)
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M. Gautherie monitoring of 1245 women with Th
III increase of hyperthermia during 12 years

• patients without benign lesions
• 461 patients with benign mastopathy

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Evolution of cancer for the patients with benign
mastopathy and stable Th III increase of
hyperthermia
The percentage of Breast Cancer cases
The number of patients 461
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Evolution of cancer for the patients without
benign lesions and stable Th III increase of
hyperthermia
The percentage of Breast Cancer cases
The number of patients 784
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The Internal Temperature Difference as a
Function of Microvessel Density (MVD)
T. Yahara, 2003
Internal Temperature Difference
Microvessel Density (MVD)
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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

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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)

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Microvascular density in preinvasive lesions of
the human breastViakava P., Naccarato AG., 2004
Types of pre-invasive lessions Abbreviation MVD
Normal Normal 115
Poorly differentiated intraductal carcinoma PDIC 190
Intermediately differentiated intraductal carcinoma IDIC 167
Well- differentiated intraductal carcinoma WDIC 125
Lobular cancer in situ LCIS 168
Atypical lobular hyperplasia ALH 125
Atypical ductal hyperplasia ADH 122
Florid ductal hyperplasia of usual type FD HUT 123
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Vascular score for different breast disease
(Heffelfinger, 1996)
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RTM 01 RESImaging System
Items Specifications
Thermal abnormality (i.e. a lower or higher temperature) is detected at a depth of, cm 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 39
Accuracy of measuring the skin temperature, ?C ? 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
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RTM - Diagnosis
The temperature is measured in 9 points of each
breast and in two reference points
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RTM-Diagnosis Software
Data of the measured temperatures are
automatically stored in the computers memory to
be processed.
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Healthy Womans Field
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Thermogram of internal and skin temperature for
normal breast
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Breast Temperature Field
Breast Cancer internal temperature field
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Breast cancer thermogram of internal and skin
temperature
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Before the treatment

• The RTM-01-RES is indispensable for the
  monitoring of treatment due to the fact that it
  is absolutely harmless.

• This is a sample of the positive dynamics which
  occur during the treatment of mastitis.

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The clinical trials of RTM -01-RESThe 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
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Russian Scientific Center for X-ray-radiology,Mos
cow, 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

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Method and Materials

• Clinical examination
• Mammography
• Ultrasonography
• Doppler ultrasonography
• Mamma stintigraphy examination
• RTM method
• Biopsy
• Histology

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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
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Breast cancer types
Type of cancer Number
Non invasive cancer 6 20
? ??? ????? Introductal cancer in situ Lobular cancer in situ 5 1 17 3
Infiltrative ductal cancer 15 50
Infiltrative lobular cancer 2 7
Another types of cancer 7 23
Total 30 100
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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
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Temperature changes for tumor with high degree of
malignancy
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Temperature changes for tumor with intermediate
degree of malignancy
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Temperature changes for tumor with low degree of
malignancy
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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 80.8 19.2
4 Mammastintig raphy 84.0 16.0
5 RTM method 96.6 3.4
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The sensitivity of different methods for
cancer in situ detection
? The type of examination Sensitivity False negative results
1 Clinical examination 34 66
2 Ultrasonography 34 66
3 Doppler Ultra sonography 0 100
4 Mamma-scintigraphy 75 25
5 RTM method 83 17
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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.

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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