Thermology in the 21st century-the biomedical future of a technology based on defense oriented engineering

The development of clinical applications based on infrared telethermometry of human skin has been slower than anticipated from a risk free. Inexpensive technique that is applicable to a very large variety of clinical situations. In addition to expected antagonism from older technologies, there are three major reasons for this. First, in spite of offering quantitative information, most thermological tests have remained qualitative and subjective. Second, it has not been fully realized that abnormal thermal behavior, depicted in thermal imaging, often represents a physiological rather than an anatomical dysfunction. Most of the diagnostic information exists, therefore, in the time domain, rather than in the spatial distribution of temperature. A dynamic approach is needed, therefore, to study thermoregulatory dysfunction. Third, relatively little attention was given to mechanisms of physiological dysfunctions that manifest thermal abnormalities. Once these shortcomings are realized, thermological testing can be substantially improved by optimizing the testing conditions, including the hardware and software used. These points are illustrated by examining the case of breast cancer hyperthermia. It is concluded that breast-cancer-induced hyperthermia involves a thermoregulatory dysfunction rather than hypermetabolism or hypervascularization. Consequently, breast cancer induced hyperthermia is expected to be associated with a characteristic dynamic thermal behavior. To make them more sensitive and specific, screening tests for breast cancer must be substantially changed, including the equipment, the software and the interpretation of the thermal data. Following the same rationale, quantitative and dynamic telethermometry is expected to be extensively used in the diagnosis and management of diabetes mellitus, liver disease, arthritis, dermatology, neonatology, and neurological disorders. All of which involve thermoregulatory dysfunctions, in addition to open heart surgery, kidney transplant vascular and reconstructive surgery, where telethermometry provides real time information on perfusion or reperfusion