Long-term hyperspectral monitoring of skin oxygenation after radiation exposure
Leah R. Siegel-Reamer, BA1, Michael S. Chin, MD2, Allison Wyman, MS1, Nikole M. Connor, Meng1, Yuan-Chyuan Lo, PhD1, Shirin Sioshansi, MD1, Janaki Moni, MD1, Maria G. Cicchetti, MD1, Thomas J. FitzGerald, MD1, Janice F. Lalikos, MD1.
1UMass Medical School, Worcester, MA, USA, 2Harvard T.H Chan School of Public Health, Boston, MA, USA.
Background: Understanding changes in perfusion resulting from radiation therapy is crucial to reducing possible complications during reconstructive procedures. In radiation oncology, there are no standardized methods to predict long term changes in skin perfusion in patients after radiation exposure. Previously, our group has shown that hyperspectral imaging (HSI) can be used to assess changes in skin surface oxygenation in patients undergoing radiation therapy while in treatment. We propose the use of HSI to predict long term changes in skin oxygenation in this patient population. In this prospective clinical study, we investigate the relationship between short- and long-term changes in oxygenated hemoglobin (oxyHb) with the values obtained while in radiation treatment.
Methods: 42 patients undergoing external beam breast conserving therapy were initially enrolled. In a previous study, patients were imaged using a hyperspectral imaging device before and after each fractionated dose while in treatment. In the current study, patients were imaged at a series of follow up dates (1 month, 2 months, 4 months, 6 months, 9 months, 1 year, and 2 years after the completion of treatment). OxyHb was analyzed at two sites per patient: treatment breast and control breast. Changes in oxygenation and perfusion status were measured at the numerous post treatment dates and were compared to the last measurement recorded while in treatment.
Results: Correlation coefficients were calculated between the final oxyHb measurement in treatment and oxyHb measurement at each follow-up time point. Statistical analysis reveals that there is a trend toward positive correlation between the final oxyHb measurements in treatment with each of follow up oxyHb measurements, with the correlation coefficients consistently between 0.4 and 0.6 (p-values between 0.001 and 0.233). This indicates that acute oxyHb measurements may predict long term skin oxygenation changes up to 2 years after radiation treatment.
Conclusions: Changes in oxyHb at the end of the treatment period may serve as predictors of long term changes in the oxygenation profile of irradiated skin. Since there is a positive correlation between long term changes in oxyHb and last treatment measurements, HSI may be valuable assessment tool for predicting long term skin reactions.
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