Welcome to Thermal Assessment Services' step-by-step guide to recording thermographic images of the breast. Although the action items in these instructions are specific to TAS System Software and a FLIR Systems camera, this guide is suitable and useful when used with other installations.
Overview of the Image Recording Procedure — There are four basic phases to the examination's image recording task:
- Verify Proper System Setup
- Position Patient and Focus Camera
- Record Images and Verify Their Quality
- Upload Images For Interpretation and Reporting.
TAS System Computer Interface – Image Acquisition & Recording
The complexity of performing each task is minimized with push-button operation of an appliance paradigm. Three windows comprise the computer interface for image acquisition tasks. They are A) Image/Camera Control Window; B) Files Window, and C) the TAS System Window.
New users should press 'Continue,' below, to become familiar with the software. To set up the camera for this session, press 'Camera Setup.' If the camera is already setup for this session, skip ahead to the'Examination.'
Conventions Used In This Guide
Bold, Blue text is used to deliniate procedure phases and subphases.
Plain Text is used to convey ancillary information to the user.
Bold, Black text is used to convey a procedural instruction, e.g., Instruct the patient to...
Bold, Red text is used to emphasize an issue.
Press here to... (Fn) This type of button is used to control camera action, e.g, Press to record, autofocus, etc.
The (Fn) after the Camera Action Button represents a keyboard shortcut associated with the button command. For example, pressing Key F7 commands the camera to record the image in the Camera Control Window. With familiarity of the recording process, it is generally faster to employ the keyboard shortcuts, instead of pressing buttons using a mouse. (Note that the keyboard shortcuts are operational with FLIR Systems cameras without TAS software.)
These buttons are for navigating between pages.
Essentials For A Credible Examination
- Assure that patient preparation conforms to the TAS Examination Protocol.
- Assure that examining room conditions are consistent with the ACT Examination Protocol.
- It is important to instruct patient that the patient's breasts and axillary regions must not be touched from the start of patient preparation (cooling) to the conclusion of the image recording procedure.
- Follow the examination criteria, avoid the temptation to use shortcuts, and take care to acquire the most suitable thermograms for evaluation,
- Assure that the camera is operating and setup properly in preparation for the examination.
Note that the camera setup procedure is required once only for each camera session. If the camera has already been setup for this session, you may skip over the Camera Setup and jump ahead to the Examination Procedure page.
Camera Setup Procedure
- Assure that the camera is properly mounted, plugged into the computer, and power applied.
- If the 'Startup' dialog box is not displayed, from the Camera Control Menu Bar, choose 'Camera,' then 'Select.'
- After a brief interval, when the camera information has become bold, click it (A). A live image will appear in the Image/Camera Control Window.
- If the camera is unidentified or doesn't connect, click on 'Search Again' (B).
Set Viewing Palette to Grayscale
- From the Camera Control Menu Bar select 'View,' then 'Palette,' then 'Grayscale.'
- When the live grayscale image is visible, press 'Continue.'
EXAMINATION PROCEDURE
Patient information for images to be recorded is entered in the 'Record Settings' dialog box. If it's not already displayed, press F5 to launch. Assure the following values are set:
- All 'Pretrigger' and 'Record Conditions' boxes should be unchecked.
- The 'Record To' field should point to 'c\new_images.' If not, use the file-browse box '...' to navigate to that location.
- Under 'File Naming,' the Snapshots tab must be selected.
- Prefix and Timestamp boxes should be unchecked. Text and Count boxes should be checked. The Count and step fieldS should be set to 1.
- Place cursor in the 'Text' field, enter the patient's name.
- Review and if everything is correctly set and entered, Press 'OK,' then 'Continue.'
Patient Positioning Procedure
The importance of patient positioning and posture cannot be overemphasized. Carefully follow positioning instructions.
Typically, three images of the patient are required. They are the frontal view, right oblique view, and left oblique view.
Some patients may require additional image recordings of lateral (side) views to assure that all areas of the breasts are recorded. This is necessary when both axillary areas are obscured or hidden in the right and left oblique views.
Check box if recordings of the lateral views are needed.
The Frontal View Position and Posture
- Position patient directly facing camera, with toes aligned to a line on the floor. The patient should be 3- to 4-feet from the camera.
Camera Focusing
Camera Focusing is important. Autofocus should be supplemented with fine focusing, as necessary.
- Using short single clicks, click the + and - buttons in the Focus Control Box to fine tune image focus, if necessary. Focusing should be adjusted so the entire image is in focus.
- When finished focusing, click the 'x' to close the focus control box.
Recording the Frontal View Image
- Confirm the patient is in position for the Frontal View
- Instruct patient to move arms back so elbows are in line with patient's torso.
- Click and drag the recorded image file from the Files Window to the Camera Control Software window. Assure that the image is properly focused, and clearly displayed.
- If the image is judged satisfactory, click 'Continue.' If not, click the 'Retake' button and when the live image reappears, delete the image file (in the File window) and then retake the image.
Capturing the Right Oblique View Image
- From the Frontal Position, instruct patient to shift weight to the right foot, and pivoting over the left heel, rotate the left foot counterclockwise 90° so it remains in line with the inside heel of the right foot.
It is very important that after positioning, the patient does not shift weight from the right leg to the left leg, as this requires re-focusing.
- Instruct patient to point right nipple directly at the camera keeping the feet in place and slightly rotating the upper torso to fine adjust the rotational position.
Capturing the Left Oblique View Image
- From the Frontal Position, instruct patient to shift weight to the left foot, and pivoting over the right heel, rotate the right foot clockwise 90° so it remains in line with the inside heel of the left foot.
It is very important that after positioning, the patient does not shift weight from the left leg to the right leg, as this requires re-focusing.
- Instruct patient to point the left nipple directly at the camera by keeping the feet in place and slightly rotating the upper torso to fine adjust the rotational position.
- Adjust the camera so the breasts are centered in the image.
Recording the Right Lateral View
- Return patient to the Frontal Position, feet together and toes touching the line created on the floor.
- For lateral views, it is imperative that patient's are placed on head. If necessary, instruct patient to do so.
- Instruct the patient to rotate clockwise 90°, with the right foot ending up against and parallel to the line on the floor, with the left foot aligned next to the right foot. The left leg should be relaxed with the patient supported by the right leg.
It is very important that the patient does not shift weight from the right leg to the left leg, as this will require re-focusing.
Capturing the Left Lateral View
- Return patient to the Frontal Position, feet together, toes touching the line created on the floor, and with hands on the head.
- For lateral views, it is imperative that patient's are placed on head. If necessary, instruct patient to do so.
- Instruct the patient to rotate counterclockwise 90°, with the left foot ending up against and parallel to the line on the floor, with the right foot aligned next to the left foot as shown. The right leg should be relaxed and with the patient supported by the left leg.
It is very important that the patient does not shift weight from the left leg to the right leg, as this will require re-focusing.