Abstract
PurposeWe analyzed skin images with various color space models to objectively assess radiodermatitis severity in patients receiving whole-breast radiotherapy.MethodsTwenty female patients diagnosed with breast cancer were enrolled prospectively. All patients received whole-breast radiotherapy without boost irradiation. Skin images for both irradiated and unirradiated breasts were recorded in red-green-blue (RGB) color space using a mobile skin analysis device. For longitudinal analysis, the images were acquired before radiotherapy (RTbefore), approximately 7 days after the first fraction of radiotherapy (RT7days), RT14days, and approximately 10 days after radiotherapy completion (RTafter). Four color space models (RGB, hue-saturation-value (HSV), L*a*b*, and YCbCr models) were employed to calculate twelve color space parameters for each skin image. Skin dose measurements for irradiated breasts were performed using nanoDot optically stimulated luminescent dosimeters on the first fraction of radiotherapy. Subsequently, acute radiation dermatitis in each patient was assessed according to the Radiation Therapy Oncology Group scoring criteria at both RT14days and RTafter. Finally, several statistical analysis methods were applied to investigate the performance of the color space parameters to objectively assess the radiodermatitis.ResultsOwing to radiation-induced skin damage, R value of RGB model as well as S and V values of the HSV model for irradiated breasts increased significantly, while those for unirradiated breasts showed smaller increases. These parameters showed the longitudinal changes in color space parameters within each group and between groups over time with statistical significance. Strong correlations of the parameters for irradiated breasts at RT7days with skin doses and those at RTafter were observed with statistical significance.ConclusionThe R value of RGB model as well as the S and V values of HSV model showed relatively better performance in evaluating the acute radiation dermatitis. These color space parameters could therefore serve as useful tools to assess radiodermatitis severity in a dose-dependent manner.
Highlights
Breast cancer is one of the most frequently occurring cancer types among women worldwide
Glover and Harmer reported that the severity of acute radiation dermatitis reaches its peak approximately 10–14 days after completion of radiotherapy of the breasts; thereafter, the severity gradually decreases as the epidermal basal layer recovers [22]
We suggested a quantitative approach for evaluation of radiodermatitis in wholebreast radiotherapy, using various color space models
Summary
Breast cancer is one of the most frequently occurring cancer types among women worldwide. According to recent statistics reported by the International Agency for Research on Cancer (IARC), breast cancer ranks as the second most common cancer type and is the fifth leading cause of all cancer-associated deaths in the world [1]. Chronic radiation dermatitis results from epidermal basal layer damage due to radiation. This can be characterized by erythema and dry desquamation that can progress to moist desquamation and even skin ulceration and necrosis [8]. Prevention and treatment of radiodermatitis should be ensured for the patient to receive the full treatment effects and have a better quality of life. To this end, the severity of the radiodermatitis should be assessed and graded properly.
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