Análisis Digital Ifnfrarrojo(ADIR)

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El Análisis Digital Infrarrojo de la Glándula Mamaria ( Termografía Mamaria) ha demostrado en el pasado que su uso como una herramienta para la detección del cáncer de mama ser alta en sensibilidad y baja en especificidad como para ser recomendado su uso rutinario o estándar .
Sin embargo en años recientes 2005-2012 la investigación activa principalmente por Cirujanos Oncólogos o Cirujanos de Mama han publicado resultados interesantes( Cornell NY , Addenbrooke Cambridge , Ville Marie Montreal , Taiwan and Mexico CEPREC)

La FDA PROHIBE el uso de la Termografia como un estudio inicial o único así como el Colegio Americano de Radiología .

Sin embargo como estudio complementario ha sido aprobado bajo ( 510 k) . Incluso desde los años 80´s

La realidad es que su uso actual es promovido por Personal de Salud alternativo lo que ha conllevado una gran DESACREDITACION y CRITICA SUBSECUENTE.

Además su significado real es DESCONOCIDO para los especialistas en Cáncer de Mama: Específicamente Radiólogos y Oncólogos.

Los avances tecnológicos en imagen infrarroja , el tamaño de los equipos y la disminuicón del costo han resultado en una mejoría notable digna desde mi punto de vista de re evaluación.

El ADIR es un estudio METABÓLICO y No ANATÓMICO es por esto que su uso rutinario debe de incluirse después de los estudios morfológicos , es decir de manera COMPLEMENTARIA.

Sin embargo , el estudio infrarrojo tiene un significado relacionado con el comportamiento biológico de la lesión en estudio , ofrece información útil al medico altamente especializado , puede ayudar en diferentes NICHOS como BIRADS 0 , III , y como apoyo Diagnostico en BIRADS IV y V
Incluso ANTES de la BIOPSIA.
Puede ser de ayuda en mama densa , implantes mamarios , pacientes jóvenes menores de 50 años.
Y utilizada como sistema de MONITOREO a respuesta a Tratamientos Neoadyuvantes.
Finalmente la propuesta de escrutinio inicial es posible después de estudios controlados especialmente en países en vías de desarrollo donde la cobertura para la detección es en si DEFICIENTE.

La imagen Infrarroja podría seleccionar (TRIAGE) las formas agresivas de la enfermedad,(T1,G2_G3).
Incluso ayudar la exploración física o guiar el Ultrasonido.
Este sitio esta dedicado a los especialistas en Cáncer de Mama abiertos a las pequeñas contribuciones.

"Expandiendo nuestra Comprehensión en Imagen en la Batalla contra el Cáncer de Mama"EMC

lunes, 11 de febrero de 2013

Tiro al Arco , analogía e introduccion de la i en AiRco

Blog publicado en 
Lo comparto previa traducción
Buen día:
Well , I guess you may have an Idea......

 Highly Trained Specialists aiming at the center of the same targets at the same distance in similar conditions,
Hours , days and years of training with the best equipment possible , best trainers and 

professors , facilities and will.

Team work , teaching and learning side by side , supervision , confidence building  , tips and experience. Decision Making and Responsability.

Complementary procedures and positions that aid eventually in an accurate shot or view to try and hit the smallest , centrical target.

 And Practice and Practice and more Practice

"ArcheiRy" Breast Cancer Detection TNM Score :
We all aim to hit the MILIMETRICAL X ring Center :T1a , we are obsessed in trying to find those lesion.
Microcalcifications are Highlightened , signaled and classified.
And as far as the arows hits from the center Score of Detection is SMALLER and prognosis is Worst.

Detected Milimetrical , Lobular Carcinoma  in association to microcalcifications. 

Density , calcified structures , quality equipment , human resources , dedication experience , along with cultural , economical and scientific variables play along side by side to identify these lesions.
"In my world fewer than 3% of the cases...................and probably yours Low Income or Resource Countries"

In Developed ones maybe 15 to 30% ( yet subclinical pool maybe the same and never translate to a diseased state ....hard to know which will advance right?)

Optimal Archery Score all within the yellow circles

Yet in real scenarios : Arrows or attempts will hit most of the times by highly trained professionals within the yellow and red circles.

That would be : Usual Breast Cancer Detection usually hits lesions around

1 or 2 cm :T1


For example , after 20 years of being a Surgical Oncologist , you can imagine the Number of patients , one of my professors made a comment of a SINGLE case of a 0.8 mm invasive ductal carcinoma.

Question is the relationship of THOUSANDS and maybe 25 years of experience a positive COST-BENEFIT one?

In the past 2012 Olympics  in the Archery Event , Highest Ranked qualified professional archers aiming at the X center probably Thousands of times and .....

 ONLY :  Khatuna Lorig started with a dead center ten that shattered the camera, but was unable to hold off Avitia (From Mexico ) who took the bronze medal with a 6-2 victory, giving Lorig a fourth place finish and making her the USA's highest individual finisher for the second Olympic Games in a row

"So that means that it really does not matter whether you hit the exact center but how many times you approach to it in order to win " EMC

Get the idea? 

Now Curious Fact : Im Dong from S.Korea holds the world record almosto 700 points and he is "Legally Blind"

"That is amazing and it means that there is something else that cannot be measured , cannot be learned or Teached  and it is mastered only by a few. Instinct and Intention are human and Medicine holds an Artistic Character difficult to define and extraordinary in a daily basis."

Infrared Digital Analysis of an Asymptomatic High Risk Patient and the corresponding standard detection Mammogram and Ultrasound:

Size eventually turned out to be 1.2 centimeters


Breast Cancer Detection should be accurate enough to hit the smallest size or target lesion. Mammography is still the gold standard for detection in some cases and ages , but it is a complicated an expensive procedure for most countries. 

Its frequency and age of first mammogram are in constant review and currently under fire. 

The cost benefit ratio is in doubt.

And the survival benefit because of SOLELY the Mammographic detection is Challenged mainly because now we have a better treatment.

For me : Infrared Imaged , digital and renewed holds promise to possibly detect lesions where Xray has its inherent difficulties or is unavailable for whatever reason.

Detection requires experience , equipment teachers , facilities resources and practice. 

Yet art and innovation even if Infrared is considered Nearsighted or legally blind for breast cancer  , may actually help and "break" current records and statistics.....EMC

To target the center is great , but if all the lesions where found UNDER the RED CIRCLES , at least my country Score and Prognosis would be Higher and Better  than it actually is.

Would you like to join?

Can we bring the i into Archery ?  and turn it into ArcheiRy?

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