What Is Contact Regulation Thermography?

Thermoregulation is the control of body temperature. The body holds its core temperature within a very narrow range despite large swings in environmental temperature and physical activity, because strict temperature regulation is necessary for the optimal function of hundreds of enzymatic reactions.

Contact Regulation Thermography (CRT) is a thermodynamic diagnostic method that uses the physiologic behavior of the body's skin temperature when exposed to a cold stimulus to assess the functionality and health status of certain organs, glands, and tissues. It involves measuring the temperature of specific points on the body surface twice — once as a baseline, and again after a roughly 10-minute cold challenge.

As Petra Blum, MD (former President of the International Medical Academy of Thermography) described it: contact regulation thermography offers information about early cellular and metabolic dysfunction — disturbances that most often precede overt disease — allowing clinicians to observe what the body is doing before it becomes dysfunctional enough to create an irreversible problem.

Research and Investigations

Investigators across Denmark, France, Germany, Italy, Japan, the United Kingdom, and the United States have studied the efficacy of contact thermography — and, more recently, liquid-crystal contact thermography — in detecting diseases such as cancer. Studies of breast abnormalities found contact thermography to be an effective diagnostic tool with high sensitivity for detecting breast abnormalities; abnormalities in breast-cancer patients were associated with increases in local regional hyperthermia related to the tumor, making it a useful adjuvant for diagnosing suspected breast neoplasms.

Contact-thermography systems have historically carried indications, under US FDA 510(k) clearance, for use as an adjunctive diagnostic device in:

  • Abnormalities of the female breast
  • Peripheral vascular disease
  • Musculoskeletal disorders
  • Extracranial cerebral and facial vascular disease
  • Abnormalities of the thyroid gland
  • Various neoplastic and inflammatory conditions

Representative findings from the literature include:

  • Pubertal breast development: An Italian study found contact thermography useful in evaluating pubertal breast development and in differentiating premature thelarche from true precocious puberty (Frejaville, Pagni, Cacciari et al.).
  • Benign breast pathology: In an Italian sample of 12,000 patients, contact thermography proved reliable in patients under 30 for detecting benign pathologies or palpable breast nodules (Sforza, Ballerini, Russo et al.).
  • Benign vs. malignant differentiation: Geshelin and colleagues reported contact thermography to be a valuable supplementary modality for distinguishing breast cancer from benign tumors.
  • Large cohort: Gautherie and Gros, evaluating 58,000 women over 12 years, reported that contact thermography made a significant contribution to the assessment of patients suspected of breast cancer.
  • Prognosis: In a Japanese study, patients with abnormal contact-thermography profiles had cancer recurrences at more than one site (Ikeda, Abe, Enomoto et al.).

Contact thermography has also been applied to deep vein thrombosis, surgical wound healing, chemical-irritant skin damage, diabetic foot ulcers, temporomandibular dysfunction, respiratory infection in pregnancy, childhood migraine, trigeminal (fifth cranial nerve) neuralgia and facial pain, and lung cancer.

History

The link between temperature and disease is nearly as old as medicine itself. The first recorded use of thermobiological diagnosis appears in the writings of Hippocrates (c. 480 B.C.): a mud slurry was spread over the patient, and areas that dried first were thought to indicate underlying organ pathology.

After Galileo introduced the thermoscope, thermometry evolved slowly and became established in medicine in part through the 19th-century work of Carl Wunderlich, who published temperature recordings from over one million readings in more than 25,000 patients using a foot-long axillary thermometer. He established a normal range of 36.3–37.5 °C, with temperatures outside this range suggesting disease.

In the 1940s and 1950s, military research into infrared systems for nighttime troop movements ushered in a new era of thermal diagnostics. Diagnostic imaging thermography arrived in 1957 when R. Lawson discovered that skin temperature over a breast cancer was higher than over normal tissue. While infrared image thermography developed in the 1950s, other scientists in Germany pursued contact thermography and the physiological thermal-regulation patterns that develop during illness:

  • 1953: Dr. Ernst Schwamm developed thermal functional diagnosis — a contact thermography he later called thermal regulation diagnosis.
  • 1954: Dr. Schwamm founded the German Society of Thermography and Regulation; Dr. Arno Rost, a German physician-researcher, was elected its president. Rost devoted his career to regulation-thermography research and, with his wife Dr. Jutta Rost, published several texts on contact regulation thermography.
  • 1975: A standardized set of measurement points was defined by Dr. Arno Rost, and development of dedicated contact-regulation-thermography measurement equipment began.
  • 1980: The Eidatherm — a predecessor of today's computerized contact-regulation-thermography systems — was developed.
  • 2000s: Decades of accumulated research data were compiled and used to develop the modern computerized system, subsequently re-engineered into its present-day form.

Modern infrared imaging systems, by contrast, produce high-resolution images of body-surface temperature by translating emitted infrared radiation into a color map called a thermogram. In healthy people the skin's thermal pattern is symmetrical, consistent, and reproducible for a given individual.

Contact Regulation Thermography vs. Infrared Thermal Imaging

  • Contact regulation thermography is a functional diagnostic. It applies a cold challenge and measures the regulatory capacity of more than 20 organs, glands, and tissues.
  • Infrared thermal imaging is a static image. It does not assess regulatory capacity and is not as organ-specific; it provides no functional information.

Many clinicians still hesitate to use thermography despite a substantial research base and continued technical improvement — largely because its physical and biological basis is unfamiliar. Functional diagnostics remains in its infancy compared with structural imaging (X-ray, MRI), which maps directly onto conventional teaching in anatomy. Thermography instead draws on thermodynamics and thermokinetics.

The Procedure

Contact regulation thermography rests on a double measurement of skin temperature at 119 defined points on the body surface:

  1. The patient sits fully clothed in a slightly cool room (20–23 °C) for 10–15 minutes to acclimate.
  2. The technician measures points on the face and neck with a contact temperature probe.
  3. The patient undresses from the waist up; measurements are taken on the arms, chest, upper and lower abdomen, back, and breasts.
  4. The patient then disrobes from the waist down and sits in underwear, arms at the sides, exposed to the cool room air for about 10 minutes. This exposure challenges the body's temperature-regulation processes.
  5. While still undressed, the same points are measured a second time.
  6. The software analyzes the paired data and produces a graphic thermogram, a reaction profile, and an interpretation — with an immediate printout.

Principles of Regulation Thermography

Interpretation uses both the absolute temperature values and the differences between the before- and after-cooling measurements. Observed patterns are classified by regulation type — normal, hyporegulation, hyperregulation, rigid regulation, and paradoxical regulation — and used to assess functional pathology.

The method rests on the physiological premise that diseases (or their pre-phases) change the body's ability to adapt to ambient temperature. The healthy body continuously balances heat production and loss to maintain a characteristic temperature pattern determined by organ/gland/tissue function, anatomy, and thermodynamics. The liver produces substantial heat, distributed by the blood. Normal human core temperature is about 37 °C.

Neurophysiology: Why Skin Temperature Reflects Organ Function

Heat distribution is governed by many organ, glandular, and neurological components. Most body heat is generated in deep organs — especially the liver, brain, and heart — and by skeletal-muscle contraction. The control center is the hypothalamus, which receives input from two sets of thermoreceptors: (1) receptors within the hypothalamus itself, monitoring core blood temperature; (2) receptors in the skin, monitoring external temperature. Using both, the hypothalamus signals the autonomic nervous system to adjust body temperature.

The key mechanism is the visceral-cutaneous reflex (reflex arc). Information flows from skin to afferent (sensory) nerves to the spinal cord, becomes organ input, and — depending on the organ's health — is relayed back through the cord to efferent nerves connecting to the skin. Because of embryonic development, nerves exiting the spine between two vertebrae innervate a horizontal segment of the body. Pathological change in an inner organ can therefore locally influence skin metabolism and temperature via this reflex arc — the physiological basis of the method.

The Measurement Points and Their Corresponding Organs

To achieve comparability, a standard set of points was defined in 1975, grouped into three subsets: the 6 standard areas, the dental/jaw areas, and the mamma (right and left). The cubital fossae of the elbows are measured twice — at the start and end of each series — to evaluate general regulatory capacity and temperature laterality.

  • Area 1 — Head: glabella (reference), radix nasi, frontal sinus, temple, inner eye, mastoid, ethmoid, maxillary sinus.
  • Area 2 — Neck: tonsil, inframandibular gland, sternocleidomastoid, supraclavicular fossa, infraclavicular fossa, thyroid lobe, thymus.
  • Area 3 — Chest: sternum, pectoralis lateral edge, intercostal points.
  • Area 4 — Upper abdomen: solar plexus, stomach, liver, gallbladder, pancreas.
  • Area 5 — Lower abdomen: small intestine, colon, appendix, uterus/prostate, ovary/lymph.
  • Area 6 — Back: kidney, sacroiliac.
  • Dental/jaw areas: points over all 32 teeth, four quadrants of 8 points each. Posterior teeth regulate cooler than anterior teeth, producing a sine-wave pattern.
  • Breast areas: measured mainly in women, each breast at 11 points. Primary abnormal patterns: hot spots in the mamma; rigid regulation points; right-to-left asymmetry > 0.7 °C; chest asymmetry > 0.5 °C; pectoralis hot spot/asymmetry > 0.5 °C; rigid sternum; rising chaos index.
For informational purposes only; not specific medical advice. Consult a qualified healthcare provider.