Document Type

Conference Proceeding

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Publication Title

Medical Physics


Purpose: To evaluate skin toxicity throughout breast radiotherapy by visualizing variations in Eulerian amplified microcirculation and correlating to skin temperature as measured by a thermal camera. Methods: High-resolution monochrome video recordings and thermal images were acquired for four breast cancer patients prior to radiation treatment followed weekly over 3-5 weeks. During these visits, the radiation oncologist assessed the patient’s skin following the CTCAE scoring system. Videos were amplified by a factor of 100 for frequencies near the patient's measured heart rate (as measured by a fingertip pulse oximeter) with a bandwidth of 0.2Hz, based on a technique developed by CSAIL at M.I.T. The amplitude of the dynamic changes during cardiac cycle were assessed as a ratio of the regions of interest (ROI’s) within the treated breast compared to the contralateral breast for normalization. Maximum skin temperature was evaluated in the treated breast ROI each week. These metrics were compared to provide a correlation between a novel technique for assessing skin toxicity with a known surrogate of skin damage. Results: This computational technique was able to visualize subtle color changes due to blood flow that would have otherwise been invisible to the clinician’s eye. The increasing change in amplitude between the treated and contralateral breasts was found to correlate with the changes in maximum temperature observed within the treated breast. These increasing changes were detected prior to visible skin erythema over treatment. Conclusion: Eulerian amplification was found to be capable of detecting non-visible changes in microcirculation based on amplification of subtle skin color changes in this feasibility study. These detected changes followed similar trends to changes in skin temperature over treatment. The measured amplitude changes provide a surrogate of skin damage and thus yield a novel technique for evaluating skin toxicity during breast radiotherapy prior to clinical manifestation.





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