Ask the right questions before investing in a DITI System.

When you're planning to invest in a DITI system. Remember, you're buying more than just a camera, you're integrating a whole new technology into your practice. Don't be confused by technical mumbo-jumbo.

The questions you need to be asking are:

• Is the system I am going to purchase really suitable for the application?
• The technology seems to be constantly changing. Will future upgrades be necessary and at what cost?
• Will the system be economic from a business perspective? (Can the system make money for me?)
• What's the total cost of ownership for the system?
  • Any high cost maintenance items?
  • Calibration Intervals? Calibration costs?
  • Are there extra charges for ‘peripherals'?
  • Are you charged for Software updates?
  • Are the Doctors interpreting images certified Thermologists? Who certifies the doctors ?
  • How much does the interpretation service cost?
• Can I get immediate help if I have technical problems?
• Who interprets the images I take?
• How many systems do you have installed in the USA and Worldwide?
• How long have you been selling these systems?
• Can I contact a list of your system users ?
  

Q. I heard the Meditherm system was manufactured overseas somewhere. Does that mean I won't be able to get support in the USA?
A. First, the Meditherm camera is manufactured in the USA and is fully compliant as a medical device. Second, factory phone support is available between the hours of 0700 to 1800 Pacific Coast Time. Outside of phone support hours, response to e-mail questions is normally within 12 hours.

Q. Can I get financing for the system?
A. We have several leasing companies we work with. Professionals can be approved within 24 hours. Non professionals normally need have been in business for 2 years or more and have a clean credit record. If you're just starting out there are programs available at slightly higher rates and may require a deposit. Contact us for details.

Q. What are typical monthly payments?
A. Typical payments will be under $800/month. Three to four full-body or six to seven Region-of-interest scans per month will cover the equipment lease costs.

Q. Can I make money with DITI?
A. We have a Microsoft Excel demo program that allows you to calculate payback based on your projected costs. Contact us for a free copy.

Q. What is DITI?
A. DITI, or 'Digital Infrared Thermal Imaging” is an imaging technique for measuring and displaying body temperature. It is radiometric; it measures temperatures. It relies on the principal that all objects at a temperature above 0 ° K (absolute zero) radiate infrared energy. The amount of radiation is a function of the body's physiology. Meditherm's DITI camera captures and records this energy and converts it to an image that can be viewed on a computer. Temperature data is digitized and retained for analysis and archiving.

Q. Why doesn't the Meditherm camera measure from 0 to 300° C?
A. Because we have optimized for sensitivity within the range of human physiological temperature.

Q. I hear from some people that you need to "cold stress" the patient. What is "cold stressing? Do I really need to do it?
A. Cold stressing is a test to measure sympathetic function, It is a useful test for a number of conditions including RSD (CRPS). Protocols used with the Meditherm system for breast screening do not require routine cold stressing but it may be requested by a referring physician or reading thermologist.

Q. I was told that grayscale thermograms were higher resolution than color, why don't you show grayscale ?
A. Nowadays there is no difference in resolution between color and grayscale with modern digitized images. When images were viewed on an old TV screen, it took three phosphors on the cathode ray tube to make one color dot….. it only takes one phosphor to make a shade of grey, the resolution in black and white therefore, would be three times greater than it was in color.

Q. What is the difference between high definition thermography and other types ?
A. Just about all modern cameras provide high-definition images.  The ‘definition’ of a thermogram relates to how many individual temperature measurements are taken to build the image. The actual definition is not as important as how accurate and sensitive those temperature measurements are. The higher the definition, the better the picture will look but this does not mean that the accuracy is any better.
Describing a thermogram as ‘high definition’ maybe confusing and misleading as most so-called high-definition images are produced by software manipulation of the data.
Low definition would be considered below 160 x 120 pixels. Industry standard is between 160 x 120 up to  320 x 240 pixels. High-definition would be considered above this and can be as high as 640 x 512 pixels.

Q. Why do I need to come back in three months for another breast study ?
A. The most accurate result we can produce is change over time. Before we can start to evaluate any changes, we need to establish an accurate and stable baseline for you. This baseline represents your unique thermal fingerprint, which will only be altered by developing pathology. A baseline cannot be established with only one study, as we would have no way of knowing if this is your normal pattern or if it is actually changing at the time of the first exam. By comparing two studies three months apart we are able to judge if your breast physiology is stable and suitable to be used as your normal baseline and safe for continued annual screening.
The reason a three-month interval is used relates to the period of time it takes for blood vessels to show change…… a period of time less than three months may miss significant change…….. a period of time much more than three months can miss significant change that may have already taken place.
There is NO substitute for establishing an accurate baseline. A single study cannot do this.

Q. Everybody talks about resolution. What is resolution? Is resolution important?
A. First, there are a couple of resolutions that apply to IR cameras. There's spatial resolution and there's thermal resolution. Spatial resolution is related to the number of pixels in an image. This is analogous to today's digital cameras and their number of pixels/picture, e.g. 2 megapixel vs. 3 megapixel vs. 4 megapixel, etc. For many or most applications 2 megapixels will provide excellent pictures for most settings in fact unless you try to zoom in you would be hard pressed to tell the difference between 2, 3 or 4 megapixels. However, you will find a significant difference in image file sizes and camera costs. The point here is that the 2 megapixel camera will work perfectly well for routine picture taking. Using IR cameras for scanning humans works much the same way. The human body doesn't exhibit significant temperature changes over very small areas. The skin tends to form a continuous surface and heat spreads out smoothly over large areas. In fact research has shown that good pattern recognition could be performed with IR cameras having resolutions as low as 160 pixels by 160 pixels ( total pixels~26,000).

Thermal resolution is a measure of a camera to detect very small temperature differences. Say for example one wanted to see 0.25 ° C differences on a surface, you would need a camera capable of detecting much smaller differences. As a practical matter, the human body has a typical surface temperature ranging from just over 30 ° C to around 38 ° C. Temperature variations on an individual will fall into that range of temperatures. Meditherm cameras are optimized for viewing this temperature range. The color scale is set so that maximum contrast can be achieved to show findings that relate to pathologies that would not otherwise be seen.

Want smooth images- use 256 color steps.
Want maximum contrast use 8 degree C range and 16 color steps.

Meditherm's extensive testing protocols are designed to work with the 8 degree thermal window and 16 colors of the 'Medical Map'.

Q. Is system stability important?
A. Yes! Stability is the characteristic in a system that allows you to accurately perform comparative studies over time …. (minutes / hours / weeks / years) to detect any changes . It is because the Meditherm camera has such excellent stability that screening breast studies can be performed with confidence; it is due to this stability that certified thermologists (MD's) can reliably analyze images statistically and provide reports to the thermographer.

Q. I notice some IR cameras use many more colors in their displays. How come Meditherm only uses 16?
A. We do give you the choice of many different color displays including the ‘smooth' looking 250 color scale. Our default color scale uses 16 colors that make visual identification of temperature differences easier and enhances pattern recognition.

Q. I recently saw a camera that had a real fast scan. Yours doesn't. What's the difference between that one and the Meditherm DITI?
A. There is a trade off between speed and sensitivity / accuracy which applies to all systems. The Meditherm Pro system uses two scanning speeds that give the best combination of speed, sensitivity and accuracy so you don't have to pay for speed that you don't need! The Meditherm IRIS system does deliver real time speed (30 frames per second) and provides sufficient sensitivity for medical imaging.

Q. What's the difference between a scanning camera and a focal plane array camera?
A. There are several broad categories of imagers. They can be lumped into groups as follows:

Single detector/scanning systems, scanned/linear array and staring or focal plane array. Each has characteristics somewhat unique to itself, but each can be made to read temperatures (radiometric).

Scanning systems use a single detector and have a scanning mechanism in the optical path which allows an image to be constructed. A major benefit to this approach is that the single element is making all the measurements. Differences in element sensitivities or bad elements, which occur in focal plane array devices, don't occur thus thermal uniformity is quite good. The downside to scanning cameras is they take longer to image, but for stationary objects where temperatures aren't changing rapidly (as with medical imaging) this is a non-issue.

Focal Plane Array or staring array cameras (FPA's) have the benefit of providing fast scanning. Images are formed in "real-time". Each element in the detector array corresponds to a pixel element in the displayed image. Until recently, FPA's required cooling to be useful. Liquid nitrogen was used for a long time. Today closed cycle Sterling Coolers are frequently employed. Downsides to these cameras are expensive replacement cost for coolers and the fact that there are dead pixel elements and different sensitivities across the detector which must be compensated for (or assigned a value).

A new type of FPA, one that doesn't require the Sterling cooler, is becoming more popular. This is known as the micro-bolometer. It has the same issue with dead or lower sensitivity elements.

This type of detector is really a hybrid of the other two. It uses a linear array, offers higher scanning speed than the Scanning detector, but considerably slower than the Focal Plane Array detectors. To some degree it suffers from the bad pixel syndrome but since there are fewer active elements it's a smaller issue. It also needs a cooler, which can be a costly maintenance item.

The third style, the linear array, uses a line of detectors which are scanned. This is a cross between a scanned single element and a focal plane array. It provides marginally faster scans but also has some of the same bad pixel issues. Currently, linear array cameras use detectors that require mechanical coolers or use Liquid Nitrogen as the cooling element. Images, after averaging, can be quite good.

Both FPA's and Linear array cameras have noisier displayed images and are generally averaged before saving an image. Signal averaging ads to the overall acquisition time thus reducing the seeming advantage over scanning systems.

Q. Who certifies your thermographers?
A. Meditherm provides technician training courses at Duke University that are approved by the American College of Clinical Thermology Inc.

Q. Do I have to be a doctor to operate the camera?
A. No. Anyone with computer skills can be trained as a thermography technician.

Q. How long does it take to learn to interpret images?
A. Firstly, there is no necessity for learning to interpret images. With the Meditherm system you have access to an online interpreting service that is staffed by fully certified MD's. If you do wish to interpret and report images, Thermology courses are conducted by the American College of Clinical Thermology, 300 hours is required for board eligibility.

Please contact us with any other questions we can add to this list. sales@meditherm.com