ThermEval's ACT Examination is an easy-to-perform, non-invasive disease screening procedure for detecting signs of subclinical coronary artery atherosclerosis, stenosis of the carotid arteries, and various thyroid dysfunctions.
The patient is prepared pursuant to a rigid protocol, then a precision infrared-sensitive camera records the thermal 'fingerprints' created by each of these diseases. The recorded images are uploaded through the internet to Thermogram Assessment Services, where innovative computer techniques are employed to objectively assess and report the risk for development of the diseases.
The ACT Examination seeks thermal signs that reveal the presence and severity of the diseases. A positive finding is not a diagnosis of illness or disease. It provides an objective means for evaluating a specific indication of risk for disease and the need for comprehensive evaluation. A negative finding does not preclude the possible presence of significant pathology.
Thermology is a medical science that derives diagnostic indications from thermal artifacts and patterns on the human body.
The organs beneath the skin, blood vessels, benign sources, and metabolic processes all radiate heat. A portion of the radiated heat reaches the surface of the skin and composes a stable thermal pattern, with the temperature of the skin at a specific point related to the heat transferred from the organs to that point on the skin.
Thermology is an old science. Hippocrates is said to have painted his patients with a thin layer of mud, correctly reasoning that the mud first dried over the region of pathology. The FDA first recognized the efficacy of thermography in 1982, when thermographic examination of the breast was approved as an adjunct to mammography for screening women for early signs of breast cancer.
Today, thermology is often called infrared imaging or thermography, as it uses special infrared-sensitive cameras to capture and digitally record images of the variations in surface temperature of the skin. The recorded images are called thermograms.
Thermograms are viewed as anatomical images in temperature-related colors or in grayscale. Each color or shade of gray represents a range of temperatures. An example temperature scale:
Thermal patterns aid in disclosing a variety of physiological processes, both normal and pathological. Some are thermal artifacts reflecting the physiological function of the underlying organ, while others are employed to disclose diseases by way of evidence-based reasoning derived from the factual presence of multiple thermal characteristics known to be symptoms of disease.
The thyroid and components of the carotid evaluations are examples of the former, while atherosclerosis and carotid stenosis are disclosed by evaluating the thermal characteristics of twenty-five regions on the face and neck and correlating those findings with carotid health.
Indications for thermal examinations abound. Vascular disorders, deep vein thrombosis, peripheral circulatory disorder, neuromuskuloskeletal issues, breast cancer risk assessment, carpal tunnel syndrome, the full list is long and comprehensive.
The ACT Examination was developed to address the prioritized health needs of the maturing Baby Boomer population. It is therefore concentrated on three of the top four causes of death among those 65 and over.
Thyroid Disorder Detection
A hyperactive thyroid gland rapidly metabolizes generating excessive heat, which produces a region of elevated temperatures over the hyperactive thyroid lobe. Similarly, a hypoactive thyroid gland metabolizes more slowly and generates less heat, resulting in a cooler region over the dysfunctional lobe.
In the following thermogram, the warmer (yellow) area pointed to by the arrow indicates an inflammation over the left thyroid lobe. The cause of the inflammation is unknown, but could indicate hyperthyroidism or an inflammation caused by malignant or benign processes. In any event, it is a positive ACT finding that supports further clinical investigation.
This patient was originally diagnosed absent clinical thyroid dysfunction. The ACT Examination exposed the inflammatory process, and subsequent comprehensive examination revealed multiple treatable cysts as the cause of the inflammation.
Carotid Artery Evaluation
The common carotid artery forks into the internal and external carotid arteries in the neck and is a common site for blockage. Sophisticated digital processing of the infrared images offers the visualization of carotid obstructions, as shown in the following images:
The far-left image shows common carotid artery, the fork, and both external and internal carotid arteries, whereas the middle image indicates discontinuity in blood flow through the visible left external carotid artery.
(Notice that the apparent occlusion of the left carotid artery is accompanied with the left side forehead and left cheek noticeably cooler than the same areas on the right side.)
The image on the far-right illustrates the use of sophisticated imaging techniques to virtually strip away the layers of skin to more clearly expose and verify the situation.
Carotid Artery Disease Detection by Way of Multiple Observed Facts
The presence and severity of subclinical atherosclerosis or carotid stenosis is disclosed in the ACT Examination by detecting and processing subtle signs of thermal asymmetry between multiple specified regions on the left and right sides of the face and neck.
The ACT Examination is based on the solid principal that humans are symmetrical, with the left and right sides in the perfect body being mirror images of each other. Owing to vascular structural symmetry, the thermal patterns of healthy individuals are relatively symmetrical temperature distributions. Departure from this normal right/left thermal symmetry indicates abnormality and the possible presence of disease. The more serious the disorder, the more pronounced are the differences in thermal symmetry. Conversely, the more pronounced the differences, the more serious is the underlying cause.
The left and right carotid arteries branch until their successors become capillaries identified with specific regions on the face. These regions, e.g., zygoma, maxilla, etc., may be mapped to different branches of their respective carotids. A blocked or partially blocked carotid branch results in less blood to the facial region associated with that branch, and when multiple cool regions are detected, the greater the number of branches are experiencing diminished blood flow, and the greater the risk that carotid stenosis is the cause.
The notion that one or two cool regions on the face evidences serious vascular disease is of little or no merit. Credible evidence-based predictions require multiple independent thermal signs. The greater the number of signs employed in the analysis, the greater the accuracy, validity and integrity of the evaluation. The ACT Examination maps the carotid tree to identify twenty-five independent regions of the face and neck.
Each of twenty-five independent regions of the face and neck evidencing thermal abnormality derives a numerical score based on its statistical pathological significance. The sum of the scores of identified thermal sign is divided into five classes, with each class indicating an assessment of increased risk of carotid stenosis and stroke risk. The five classes are Normal, Borderline, Equivocal, Diagnostic, and Conclusive evidence of amplified risk.
Consider the following set of images:
The woman's images on the left are those of a normal healthy individual evidenced by almost perfect thermal symmetry between the right and left sides of the face and neck. The images on the right tell a different story.
The images of the male reveals four thermal signs associated with carotid stenosis on the left side of the face and neck. Thermal asymmetry is evidenced by reduced heat emission from the left side of the forehead, cheek, temple and the region over carotids. Noteworthy is the absence of a carotid thermal signature on the left side of the neck. This, along with three significantly cooler areas on the left side of the face is conclusive thermal evidence of severe risk for disease of the left carotid artery.
Coronary Artery Atherosclerosis
The detection of subclinical coronary artery atherosclerosis is inferred by symmetrical reduced thermal emissions from both sides of the neck and from the carotid arteries. When the carotid arteries and surrounding neck area are both abnormal, the most logical common cause, coronary artery atherosclerosis, is suspected.
To assess abnormality, a baseline reference temperature is established from the average temperature of the base of the shoulders and the manubrium, two areas where atherosclerosis is almost unknown. In a healthy patient, the temperature of the broad areas of the neck adjacent to the carotid is elevated relative to the baseline reference, and the carotid temperature is elevated relative to those broad areas of the surrounding neck.
If the average temperatures of the broad areas of both sides of the neck surrounding the carotid arteries are below a threshold related to the baseline reference, and concurrently the temperature of each carotid artery is below a threshold related to the average temperature of the surrounding neck area, this is evidence of reduced blood flow to both common carotid arteries, suggesting, as the most common cause, coronary artery atherosclerosis.
Three technical requirements must be met to perform a meaningful ACT Examination – Quality camera, ergonomic software, and credible image interpretation.
The camera capturing the images must be of high enough quality to assure the images clearly and accuracy display the information required to perform a detailed analysis. Image recording requirements for performing the ACT Examination (and other typical indications for thermography) require a minimum native 320px X 240px image resolution, stability, accuracy and precision equal to, or better than current standards for medical purposes. ThermEval's entry level imaging system comfortably satisfies these criteria.
Camera-control and image handling software must be designed to minimize operator errors. ThermEval imaging systems employ a user-interface design that renders the system an easy-to-use, push-button appliance.
Image interpretation! By their very nature, thermograms are difficult to analyze and interpret, and require a highly trained individual to perform the task. Act Examination images are exclusively interpreted by ThermEval's affiliate, Thermogram Assessment Services. To assure the objectivity and accuracy of its interpretations, TAS created and employs proprietary software that assesses twenty-five important quantitative thermopathological markers to reach its conclusions.
A significant patient benefit of the ACT Examination is its affordability. Technological progress is to thank for financial viability.
Over the past ten years, technological advances have significantly improved camera image quality, resolution, thermal sensitivity, and in turn, the ability to assess risk of disease with improved precision. These critical advances were accompanied with dramatically-reduced pricing. Today, the cost of the cameras and computers required for the ACT Examination are now a fraction of historical prices.
Five years ago, the camera alone cost $25,000+. Today, ThermEval's entry level ACT Examination System includes a high quality camera, laptop computer, ergonomic software, and at-your-site training for $15,995.
Financial benefits to the practitioner render the ACT Examination affordable for the patient. With ThermEval financing, cash outlay is negligible, the entire purchase is tax-deductable in the current year, and monthly payments are low. The procedure itself requires only about ten minutes of medical office staff time to perform. Monthly break-even is about $260, or less than 1.5 examinations per month. The $225 cost to the patient is an affordable, attractive expense that is far less likely to be deferred by at-risk asymptomatic patients than the alternative uncovered cost for comprehensive tests.