2010 IEEE EMBS Conference on Biomedical Engineering & Sciences (IECBES 2010), Kuala Lumpur, Malaysia, 30th November
- 2nd December 2010.
Interpreter for Breast Thermogram Characterization
V. Umadevi and S. V. Raghavan
Department of CSE
Indian Institute of Technology Madras
Chennai, India
{umadevi,svr}@cs.iitm.ernet.in
Abstract— Breast thermography is a painless, non-invasive
and non-ionizing medical imaging technique useful for early
breast screening. Study shows that abnormal breast thermal
image initiates the requirement for detailed diagnosis to probe
the presence of cancerous cells. Hence identification of the
subject’s breast thermal image as normal or a case for follow-
up is a necessity for diagnosis. Breast thermal image is a
visual representation of breast skin surface temperature. Direct
visual interpretation of breast thermal image to conclude
whether it is normal or a case for follow-up (abnormal) is
tedious. In this work we propose a interpretation system for
characterization of breast thermal image as normal or a case
for follow-up. Our proposed system is represented as ITBIC
interpreter. Breast thermal images obtained from 50 female
volunteers were characterized using ITBIC interpreter, results
are matching to clinical findings. With graphical user interface,
ITBIC interpreter will be a useful tool for initial and mass
screening of subjects.
Keywords - Breast thermography; Cancer; Interpreter
I. I NTRODUCTION
All objects above zero kelvin emit infrared radiation. The
Stefan-Boltzmann law gives the relationship between the
infrared energy emitted from a body and its temperature.
Thermography or Thermal scan is a process of capturing
infrared radiation emission and converting it into equivalent
temperature values. Hence thermal image is a visual rep-
resentation of surface temperature. Thermal scanning finds
applications in the area of breast cancer screening, vascular
disease detection & diagnosis and other such uses related
to superficial human body organs. The metabolic rate and
blood perfusion rate of pre-cancerous & cancerous cells are
high when compared to normal cells. Hence body surface
temperature around the area of pre-cancerous and cancerous
cells will be slightly higher than normal, there by increasing
the thermal radiation emissions from the surface around
the pre-cancerous and cancerous area. In thermal images of
such abnormal cases the tumorous area will be seen as hot
spots. Upon detection of abnormality in thermal image (or
thermogram) the case should be subjected to further clinical
evaluation, as abnormal thermogram is a biological risk
marker for existence of or possible development of breast
tumor [4]. Popular belief is that breast cancer detected at an
early stage is curable. With thermography, breast cancer can
be detected 8-10 years earlier as compared to the existing
methods in use [1].
Example a volunteer’s breast thermal image is as shown
978-1-4244-7600-8/10/$26.00 ©2010 IEEE 150
Dr. Sandeep Jaipurkar
Vijaya Scans
Vijaya Health Centre
Chennai, India
drsandeepjaipurkar@rediffmail.com
in Fig. 6. Direct visual interpretation of breast thermogram
to conclude whether it is normal or a case for follow-
up (abnormal) is tedious [2]. In this paper we propose
a interpreter entitled Infrared Thermography Based Image
Construction (ITBIC) system.
In literature, researchers have proposed methods such as
artificial neural network [2], color segmentation, amplitude
calculation of localized temperature increase and feature
extraction from segmented breast parts to automate the differ-
entiation process of breast thermograms. Breast thermograms
were segmented based on color value of the pixels in [5]
and [6]. Interpretation method based on temperature value
of pixels in thermogram will be a suitable choice, as it is
independent of color scheme followed for representation. In
ITBIC interpreter, characterization is based on temperature
value of pixels in thermogram. Morphological measurements
were used in [3] to calculate amplitudes of localized tem-
perature increase for abnormal temperature pattern in breast
thermogram. The amplitude value is decisive factor to differ-
entiate thermograms. For this method, manual identification
of abnormal temperature pattern in thermogram is required,
hence it is time consuming, difficult and there are chances
of missing abnormal temperature pattern.
The use of thermography in the field of medicine, specif-
ically in the field of oncology, is limited due to the shortfall
of a system to rightly interpret the thermograms. The fact
that a system to interpret thermograms would help to cross
the barrier for use of thermography in the field of medicine
stimulated us to develop a system for differentiating breast
thermograms.
II. ITBIC INTERPRETER
A. Motivation
Breast thermography being non-contact, non-invasive and
non-ionizing scanning procedure, makes it a safe method
which can be repeatedly applied on the same subject and
across all age groups. Thermal images captured by a infrared
camera can be viewed using different color palettes. Front
view of a female subject’s breast thermal image is shown
in Fig. 1 using three different color palettes. Figure 1(a) is
representation of the breast thermal image when viewed in
color palette 1. Similarly Fig. 1(b) and 1(c) are the views of
the image in color palette 2 and 3.
Thermal images can be viewed in different temperature
ranges. Breast thermal images in different temperature scales
are shown in Fig. 2. When thermal images were shown in
different color palettes and in different temperature scales to
the radiologist to diagnose whether the thermograms were of
normal or abnormal cases, it was found difficult to extract
(a) 80 to 100 Fahren- (b) 90 to 100 Fahren- (c) 90 to 110 Fahren-
the pattern of the asymmetry between the left and right parts heit heit heit
of the breast. Each breast thermogram is best viewed in
a certain temperature scale and in a specific color palette. Fig. 2. Breast thermogram - With different temperature scale
Since human body temperature varies from individual to
individual, a common temperature scale and color palette
for viewing of thermograms, by medical professionals, is
required. ITBIC interpreter provides a single common view
of the breast thermal image which simplifies characterization
of thermograms.
We used two different infrared cameras namely Ti40FT
from M/s Fluke Corp. and Varioscan-3021 ST from Jenoptik
Laser. To view images captured, specific camera compactable
softwares are to be used i.e. SmartView for Ti40FT and IR-
BIS for Varioscan 3021-ST. Sample screenshot of SmartView
and IRBIS softwares are shown in Fig. 3. Further, to view
and analyze the image, a radiologist has to get familiarized
with the software based on the camera in use. Here ITBIC
interpreter provides a common view of the breast thermal
images independent of infrared camera used, which makes (a) Smartview
it very simple for understanding and analysis of the thermal
images by medical professionals. Common interface view of
thermograms is depicted in Fig. 4.
Breast thermal scanning of 50 female subjects were carried
out. Details of the procedures are explained in section III. For
comparative analysis, the subjects were diagnosed using the
present available methods of which 44 cases were normal, 2
malignant, 3 fibrocystic disease and 1 abscess case.
B. Method
For each female subject screened, three thermal images
were captured which shows front, left and right side views
of the breast. Each thermal image is a two dimensional
matrix of temperature values, which is the representation
of breast surface temperature. ITBIC interpreter operates in
two stages. First stage identifies the body boundary and the
second stage extracts highest temperature area of the thermo- (b) IRBIS
gram. Finally ITBIC interpreter combines the output of two
Fig. 3. Thermogram viewer software specific to infrared camera
stages, to create a single image. The final processed image
simplifies interpretation of thermogram for characterization.
Block diagram of overall ITBIC interpretation system is
shown in Fig. 5.
1) Body boundary identification: During the process
of breast thermal scanning we noted down the ambient
temperature. For each breast image captured we exported
breast surface temperature values from the infrared camera.

Fig. 4. Common interface to view thermograms

The pixels of the breast thermal image are divided into

(a) Palette 1 (b) Palette 2 (c) Palette 3
two groups - First group of pixels belong to ambient or
background temperature values and Second group of pixels
Fig. 1. Breast thermogram - With different color palette belong to surface body temperature values. Divided pixel

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Fig. 5. Block diagram of ITBIC interpreter
values are then passed to the edge detector algorithm
to identify body boundary. Formal description of this
algorithms is as follows:
Here, T represents temperature data matrix (breast thermal
image). Size of T be n×m, ‘n’ number of rows and ‘m’
number of columns. Let the ambient temperature be A. The
set of background temperature pixels, B, of the image is
identified using the following expression
 obtained on female breast thermograms.
 1 if T (x, y) ≤ A ∀1 ≤ x ≤ n
B(x, y) = 1≤y≤m
0 else T (x, y) > A

Edge detector algorithm is applied on the data matrix B,
for identification of body boundary.
2) Highest temperature area extraction: From two
dimensional matrix of temperature values representing
the breast thermal image, maximum temperature value is
selected. Further, pixels of the image are grouped into
two. The first group of pixels having temperature value
less than maximum temperature minus ‘t’ (value of ‘t’ was
fixed as 1 in our experiments) and second group of pixels
having temperature values greater than or equal to maximum
temperature minus ‘t’. Formal description of this algorithms
is as follows:
m = max(T )
 0 if T (x, y) < (m − t) ∀1 ≤ x ≤ n
H(x, y) = 1≤y≤m
1 else T (x, y) ≥ (m − t)

III. I N VIVO STUDY
Fifty sets of female breast thermograms were screened at
Vijaya scans under the supervision of Dr. Sandeep Jaipurkar
(MD) using two different infrared cameras. We captured
thermal images of front, left and right side views of the
breasts. The first 27 sets were screened using Ti40FT from
M/s Fluke Corp. and the second 23 sets were screened using
Varioscan 3021-ST thermal system from M/s Jenoptik Laser.
Procedure followed for screening of first and second sets
were different. First 27 sets were screened in a room which
was air conditioned and with fluorescent bulb on. For normal-
ization, subjects were made to sit in the examination room
for 15 minutes with upper body part undressed. Then the
thermal images of the breast part were captured. Second 23
sets were screened in a room which was not air conditioned
and with fluorescent bulb off (i.e. images were captured in
a dark room). For this set of subjects, images were obtained
immediately (i.e. without normalizing) with upper body part
undressed. Subject were found to be more comfortable to
thermographic procedure when carried out in a dark room.
In this section we discuss the results of ITBIC interpreter
A. Normal case
Normal case breast thermograms are as shown in Fig. 6
and 8. Output images of ITBIC interpreter for the normal
case 1 and 2 are shown in Fig. 7 and 9. In the processed
image of ITBIC interpreter, body boundary and highest tem-
perature area was extracted from the algorithms, as described
earlier. But, boundaries of breast part were drawn explicitly
for explanation.
Case 1: Highest temperature area does not appear in the left
and right parts of the breast, in all views (Front, Left and
Right) of the breast thermal images Fig. 7(a), 7(b) and 7(c).
Case 2: Highest temperature area appears below the left and
right parts of the breast in the front view of the breast image,
Fig. 9(a) (color patch pattern represents highest temperature
area). In left view of the image, Fig. 9(b), highest temperature
area appears below the right breast. In right view of the
image, Fig. 9(c), highest temperature area appears below
the left breast. Symmetry exists in appearance of highest

Finally the output matrices B and H, generated by body

boundary identification algorithm and highest temperature
area extraction algorithm are combined to generate a pro-
cessed image. The processed image is easy to interpret and
understand. The protocol of interpreting a thermogram for (a) Front (b) Left (c) Right
characterization from processed image generated by ITBIC
interpreter is as follows: Fig. 6. Thermal scan images - Normal case 1

i The thermogram is normal if highest temperature area

does not appear both in left and right breast parts or if
it appears in collateral locations of both left and right
breast parts.
ii The thermogram requires further follow-up if highest
(a) Front (b) Left (c) Right
temperature area appears only in any one of the breast
part. Fig. 7. ITBIC interpreter output - Normal case 1

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 (a) Front (b) Left (c) Right

Fig. 8. Thermal scan images - Normal case 2

Fig. 12. MRI scan image - Abnormal case 1

(a) Front (b) Left (c) Right

Fig. 9. ITBIC interpreter output - Normal case 2

temperature area on both left and right parts of the breast

which implies it is a normal case thermogram.

B. Follow-up case
Fig. 13. MRI scan image - Abnormal case 2
Abnormal case breast thermograms are shown in Fig. 10
and 14. Output images of ITBIC interpreter for the abnormal
case 1 and 2 are shown in Fig. 11 and 15.
Case 1: Highest temperature area appears only in left part
of the breast and not in right part of the breast as shown in
Fig. 11(a). Similarly in the left view of the image Fig. 11(b), (a) Front (b) Left (c) Right
highest temperature appears only in the left breast part.
Case 2: Highest temperature area appears below right breast Fig. 14. Thermal scan images - Abnormal case 2
part only and not in left breast part as shown in Fig. 15(a).
Similarly in the left and right views of the image Fig. 15(b)
and 15(c), highest temperature area appears only in the right
breast part.
In these two thermograms, Fig. 11 and 15, highest tem-
perature area appears only in any one of the breast part (a) Front (b) Left (c) Right
which is a sign of asymmetry, which requires further follow-
up of these cases. These cases were further followed up Fig. 15. ITBIC interpreter output - Abnormal case 2
with Magnetic Resonance Imaging (MRI), which is one of
the standard scanning technique for breast cancer diagnosis.
The MRI scan result of abnormal case 1 confirmed to be confirmed to be malignant neoplasm. MRI scan images of
a fibrocystic disease. For abnormal case 2, MRI scan result abnormal case 1 and 2 are shown in Fig. 12 and 13.

TABLE I
ITBIC INTERPRETER RESULTS ON A SET OF 50 BREAST THERMOGRAMS

Radiologist assessment
Abnormal Normal
ITBIC interpreter
4 1 PPV=80.0%
Abnormal
(a) Front (b) Left (c) Right ITBIC interpreter
2 43 NPV=95.6%
Normal
Fig. 10. Thermal scan images - Abnormal case 1
Sensitivity=66.7% Specificity=97.7%

PPV Positive Predictive Value

NPV Negative Predictive Value

Among 50 female breast thermograms used for validating

(a) Front (b) Left (c) Right
ITBIC interpreter, 44 were normal and 6 were abnormal
as detected by MRI. ITBIC interpreter identified 43 normal
Fig. 11. ITBIC interpreter output - Abnormal case 1 cases and 4 abnormal cases. End result show that, of the 50

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 R EFERENCES
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cal measurement of localized temperature increase amplitudes in breast
infrared thermograms and its clinical application,” Biomedical Signal
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[4] E. Y. K. Ng, “A review of thermography as promising non-invasive
detection modality for breast tumor,” International Journal of Thermal
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[5] M. EtehadTavakol, S. Sadri and E. Y. K. Ng, “Application of K-
and Fuzzy c-Means for color eegmentation of thermal infrared breast
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[6] Luciano Boquete, Sergio Ortega, Juan Miguel-Jimnez, Jos Rodrguez-
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Fig. 16. Screenshot of the screening tool - GUI

cases, one normal case and two abnormal cases miss inter-
preted by ITBIC. Classification results of breast thermograms
by ITBIC interpreter is summarized in table I.
IV. S CREENING T OOL
Graphical User Interface (GUI), a tool to examine breast
thermograms was developed. Screenshot of the tool is shown
in Fig. 16. This tool is very handy for medical professionals
to easily analyze the thermogram. An option is provided to
choose a particular case of breast thermogram from a set of
thermograms for examination and displays front, left & right
views of the breast thermograms in the first row. Mouse-
over option is provided for these three images where the
user can click on the image and obtain temperature value at
the point of click. In the tool, second row displays processed
images generated by ITBIC interpreter. For these images also
user is provided with mouse-over option to know temperature
values. This tool when demonstrated to a radiologist showed
a very satisfied sign of reading and understanding breast
thermograms.
V. C ONCLUSION
Recent advances in infrared sensor technology gave rise to
intensive research in Breast thermography. In this paper we
presented ITBIC interpretation system for characterization
of breast thermal images. This is a tool for differentiation
of breast thermal images as normal or a case for follow-up,
which is helpful for initial and mass screening. The results
of ITBIC interpreter on 50 female breast thermal images are
promising and encouraging. Statistical analysis was carried
out on the results of ITBIC interpreter which resulted in PPV
of 80%, NPV of 95.6%, Sensitivity of 66.7% and Specificity
of 97.7%. Study of ITBIC interpreter on an enhanced set of
breast thermal images is currently under progress.

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