1. Microwave Thermography

2. RTM – Principles
The RTM-01-RES radiometer receives and evaluates the natural electromagnetic radiation (temperature) from the patient’s internal tissues at microwave

3. The Volume Under Investigation
Skin
Internal Tissues
Microwave Sensor
The Volume Under Investigation
Antenna
P=k T ΔF
K-Bolzmann coefficient
ΔF-the receivers bandwidth

4. Microwave Penetration Depth in Human Tissue

5. Temperature and Blood flow Patterns in breast cancer (M
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

6. The distribution of temperature and thermal conductivity in cancerous and healthy breast

7. Metabolic heat production, Doubling time of tumor volume (days)
Metabolic heat production as a function of doubling time of tumor volume 10 70 20 30 40 50 60
200
300
400
500
600
700
100
Metabolic heat production,
( мWt/cm3 )
Without lymph node metastases
With lymph node metastases
Doubling time of tumor volume (days)

8. M. Gautherie monitoring of 1245 women with Th III increase of hyperthermia during 12 years
patients without benign lesions
461 patients with benign mastopathy

9. stable Th III increase of hyperthermia The number of patients – 461
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

10. The number of patients– 784
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

11. Internal Temperature Difference Microvessel Density (MVD)
The Internal Temperature Difference as a Function of Microvessel Density (MVD)
T. Yahara, 2003
Internal Temperature Difference
Microvessel Density (MVD)

12. 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

13. 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)

14. Types of pre-invasive lessions
Microvascular density in preinvasive lesions of the human breast Viakava P., Naccarato AG., 2004
Types of pre-invasive lessions
Abbreviation
MVD
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
Atypical ductal hyperplasia
ADH
122
Florid ductal hyperplasia of usual type
FD HUT
123

15. Vascular score for different breast disease (Heffelfinger, 1996)

16. RTM – 01 – RES Imaging 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
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

17. RTM - Diagnosis
The temperature is measured in 9 points of each breast and in two reference points

18. RTM-Diagnosis Software
Data of the measured temperatures are automatically stored in the computers memory to be processed.

19. Temperature(ºC): Minimum 34.8, Mean 35.1, Maximum 35.4
Healthy Woman’s Field
Temperature(ºC): Minimum 34.8, Mean 35.1, Maximum 35.4
Right MG Left MG
Isotherm step

20. Thermogram of internal and skin temperature for normal breast

21. Breast Temperature Field
Temperature(ºC): Minimum 32.8, Mean 33.8, Maximum 35.3
Right MG Left MG
Isotherm step
Breast Cancer internal temperature field

22. Breast cancer thermogram of internal and skin temperature

23. Before the treatment
The RTM-01-RES is indispensable for the monitoring of treatment due to the fact that it is absolutely harmless.
Right Breast Left Breast
After the treatment
Right Breast Left Breast
This is a sample of the positive dynamics which occur during the treatment of mastitis.

24. The place of the clinical trials
The clinical trials of RTM -01-RES The total number of patients is 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
1998
85.1
76.5 3
Ontological centre
89.6
81.8 4
Maim military Hospital (Burdenko)
2001 98 76 5
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

25. 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

26. Method and Materials Clinical examination Mammography Ultrasonography
Doppler ultrasonography
Mamma stintigraphy examination
RTM method
Biopsy
Histology

27. The subjects of study Pathological changes Number 1 Ductal hyperplasia23 2
Fibroadenoma 11 3
Atypical proliferation 15 4
Breast cancer 30 5
Total 79

28. Breast cancer types Type of cancer Number % Non invasive cancer 6 20
В том числе:
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 23
Total 30
100

29. 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
hotbed asymmetry and with the presence of local
increases of temperature

30. Temperature changes for tumor with high degree of malignancy

31. Temperature changes for tumor with intermediate degree of malignancy

32. Temperature changes for tumor with low degree of malignancy

33. 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 3
Doppler Ultra sonography
80.8
19.2 4
Mammastintig
raphy
84.0
16.0 5
RTM method
96.6
3.4

34. 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 3
Doppler Ultra sonography
100 4
Mamma-scintigraphy 75 25 5
RTM method 83 17

35. 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.

36. 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%