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Hyperspectral Imaging For Clinical Assessment Of Radiation Dermatitis
Leah Siegel-Reamer, BA1, Michael S. Chin, MD2, Nikole M. Connor, MEng1, Allison Wyman, MS3, Gordon FitzGerald, PhD3, Jorge Lujan-Hernandez, MD1, Jonathan H. Saleeby, MS2, Yuan-Chyuan Lo, PhD2, Thomas J. Fitzgerald, MD2, Janice F. Lalikos, MD1.
1Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, MA, USA, 2Department of Radiation Oncology, University of Massachusetts Medical School, Worcester, MA, USA, 3Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.

Purpose: The relationship between radiation dose and acute radiation dermatitis remains controversial. No objective methods exist to assess degree of skin reaction to radiation. Previously, we have shown that hyperspectral imaging (HSI) can demonstrate that surface hemoglobin readings varied proportionally with radiation dose and skin reactions in an animal model. Correlations between skin reactions, radiation dose, and HSI oxygenated hemoglobin (oxyHb) values were analyzed in this prospective clinical study.
Methods: 42 patients undergoing external beam breast conserving therapy enrolled. Skin radiation doses ranged between (0.2 to 225) cGy per treatment fraction. Baseline hyperspectral images were obtained before starting irradiation in each patient and subsequently before and after each fractionated dose. OxyHb was measured at three sites per patient during treatment. Skin reactions were graded at each treatment encounter and compared to cumulative dose and changes in oxyHb.
Results: Each skin reaction score was found to have significantly different average cumulative doses, with skin reaction severity increasing along with increasing dose. Skin reactions had significantly different changes in oxyHb, with increasing changes in oxyHb associated with increasingly severe reactions (Figure 1).
Conclusions: There is a significant correlation between increasing radiation dose, acquisition of acute dermatitis and HSI oxyHb. Since clinical stages of acute radiation dermatitis are readily differentiated by oxyHb, HSI could be a reliable assessment tool for an objective skin scoring system during radiation treatment.


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