The issue of radiation damage to skin in conventional radiotherapy (RT) has motivated pre-clinical studies to demonstrate reduced skin toxicity and overall improved normal tissue sparing in high-dose rate FLASH RT. We address the critical need for diagnostic tools to evaluate radiobiological response mechanisms produced with FLASH RT by using low-coherence light scattering to quantify skin and tumor tissue response to FLASH versus conventional radiotherapy. A study of melanoma growth in dorsal skin window chambers on rodents in vivo following separate regiments of RT treatment was conducted with optical coherence tomography (OCT), followed by parametric texture analysis of volumetric OCT images to delineate viable and dead cell clusters in tissue. Longitudinal quantification of viable and dead cell proportion demonstrates the severity of conventional RT damage to skin in comparison with higher epidermal structural integrity preserved by FLASH radiotherapy, highlighting potential of OCT for microstructural imaging in this first-of-its-kind study.
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