According to the American Cancer Society, it is projected that 1.8 million new cancer cases will arise. Of these new cases, 15% are expected to be Breast Cancer related. For many subjects undergoing radiation therapy (RT), radiation dermatitis (RD) is an unavoidable adverse reaction to necessary treatment. As much as 95% of RT subjects will experience RD during or after their treatment plan which can range from mild erythema to full necrosis of the treated tissue. Further complicating matters, the standard assessment approach for RD, the Common Terminology Criteria for Adverse Events (CTCAE), is subjective and relies on the treating clinician’s visual assessment. Assessment of oxygenated blood flow changes holds potential as a means of assessing the severity of RD. In this study, spatial-temporal changes of tissue oxygenation, via a breath-hold paradigm, were monitored in breast cancer subjects across weeks of RT using a near infrared imaging approach. Subjects were imaged dynamically to acquire 2D spatial-temporal maps of tissue oxygenation. A Pearson’s correlation-based approach was applied to spatial-temporal oxygenation maps to determine the extent of symmetry or asymmetry in oxygenated blood flow patterns. Current results indicate that the oxygenated blood flow in tissue regions neighboring the irradiated site are affected by radiation dermatitis. These results are significant as they infer that RT induces altered oxygenated blood flow that could potentially be correlated to RD severity, apart from static tissue oxygenation measurements.
KEYWORDS: Biomedical optics and medical imaging, Medical imaging, Tissues, Chest, Tissue optics, Breast cancer, Skin, Cancer, Oxygen, Radiotherapy, Skin cancer
The American Cancer Society has estimated that a total of 1.8 million new cancer cases will arise in 2020, 15% percent of which are breast cancer. Radiation therapy (RT) is widely used post mastectomy or lumpectomy as a method of avoiding recurrence of disease in affected regions. Photon and proton therapy are among the main forms of RT currently applied to breast cancer patients. The effectiveness of photon vs proton therapy has been studied in various cancer models from differences in subjective clinical grading of radiation dermatitis (RD), a common side effect of RT. Herein, an objective physiological imaging approach using near-infrared optical techniques is implemented to quantitatively differentiate the effectiveness of proton vs photon therapy in breast cancer subjects undergoing RT. A 6-8 week longitudinal pilot study (WIRB approved) was carried out on 10 breast cancer subjects undergoing RT at Miami Cancer Institute (MCI). The chest wall, axilla, and lower neck were imaged on the irradiated and the non-irradiated (contralateral) sides of the torso to measure for tissue oxygenation changes. From preliminary analysis, it was observed that were distinct differences in tissue oxygenation and RD in the irradiated regions when compared to their contralateral nonirradiated tissue (reference). Changes in tissue oxygenation and skin toxicity (i.e. RD clinical grading) were more localized and less severe in subjects receiving proton therapy compared to photon therapy. Quantitative comparison of oxygenation changes and its correlation to the skin toxicity levels in photon vs proton therapy treated breast cancer subjects is currently carried out.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.