Abstract
Background and objectives: The possible evolution of actinic keratoses (AKs) into invasive squamous cell carcinomas (SCC) makes their treatment and monitoring essential. AKs are typically monitored before and after treatment only through a visual analysis, lacking a quantitative measure to determine treatment effectiveness. Near-infrared spectroscopy (NIRS) is a non-invasive measure of the relative change of oxy-hemoglobin and deoxy-hemoglobin (O2Hb and HHb) in tissues. The aim of our study is to determine if a time and frequency analysis of the NIRS signals acquired from the skin lesion before and after a topical treatment can highlight quantitative differences between the AK skin lesion area. Materials and Methods: The NIRS signals were acquired from the skin lesions of twenty-two patients, with the same acquisition protocol: baseline signals, application of an ice pack near the lesion, removal of ice pack and acquisition of vascular recovery. We calculated 18 features from the NIRS signals, and we applied multivariate analysis of variance (MANOVA) to compare differences between the NIRS signals acquired before and after the therapy. Results: The MANOVA showed that the features computed on the NIRS signals before and after treatment could be considered as two statistically separate groups, after the ice pack removal. Conclusions: Overall, the NIRS technique with the cold stimulation may be useful to support non-invasive and quantitative lesion analysis and regression after a treatment. The results provide a baseline from which to further study skin lesions and the effects of various treatments.
Highlights
Non-melanoma skin cancers (NMSC) are the most common human cancers, in the Caucasian population; in Italy, the prevalence of the actinic keratoses (AKs) is estimated to be around30% [1], making them a major health problem, considering their possibility of evolution into invasive squamous cell carcinomas (SCC).In the last few years, the treatment of actinic keratosis keratosis (AK) has changed and the concept of “lesion directed therapy”has been overtaken by “field therapy”
In our previous study [20], we demonstrated that there is a difference in the Near-infrared spectroscopy (NIRS) features between healthy skin and AK lesions which can be interpreted as a different vascular response in the two areas, using the same protocol and a similar statistical analysis approach
We demonstrate that the NIRS and cold stimulation approach has clear potential in the non-invasive diagnosis of AK lesions and in the quantitative analysis of their regression after topical treatment
Summary
It is well-known that chronic exposure to ultraviolet radiation (UVR) is the main risk factor for NMSC and UVR-induced photo damage can cause a field of actinic damage. This field usually presents clinically visible AKs and subclinical cell alterations The early treatment of all lesions (clinically visible and subclinical) must be considered in order to reduce the possible risk of evolution into squamous cell carcinoma (SCC) [6,7,8,9,10,11]. The possible evolution of actinic keratoses (AKs) into invasive squamous cell carcinomas (SCC) makes their treatment and monitoring essential. The results provide a baseline from which to further study skin lesions and the effects of various treatments
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