Approximately 80 percent of breast cancer patients undergoing radiation treatment develop acute skin reactions that range in severity. The more severe reactions cause discomfort and distress to the patient, and sometimes result in treatment interruptions. The severity is quite variable among patients and difficult to predict.
"Because reactions usually occur from 10 to 14 days after the beginning of therapy, if we could predict skin reactions sooner we may be able to offer preventative treatment to maximize effectiveness and minimize interruption of radiation treatment", stated Dr. Katherine Griem, professor of radiation oncology at Rush.
Researchers at Rush and Argonne are studying if three-dimensional thermal tomography (3DTT) can detect the earliest changes that may trigger a skin reaction. 3DTT is a relatively new thermal imaging process that is currently being used as a non-invasive away to detect defects in composite materials. The basic idea of thermal imaging is to apply heat or cold to a material and observing the resulting temperature change with an infrared camera to learn about its composition.
Unlike most thermal imaging studies which have quantitative limitations, 3DTT measures the thermal effusivity of skin tissue. Thermal effusivity is a measure of a material's ability to exchange heat with its surroundings.
In this study, a flash of light is used to heat up the skin. An infrared camera captures a series of images over time that display the temperature of the skin, represented by colours. An algorithm developed by Argonne is used to calculate the temperature change and determine the thermal effusivity of different areas of the skin.
"How quickly the skin cools is related to the structure underneath. Damaged skin cells have different effusivity values compared to that of healthy skin", stated James Chu, PhD, chairperson of the section of medical physics at Rush. "By identifying the earliest changes in damaged tissue, we may be able to predict acute skin toxicities." Preliminary data from the study show that marked decreases in thermal effusivity of irradiated skin occur well in advance of the development of high grade skin reactions.
"Our initial data with radiation induced skin changes are quite encouraging", stated Dr. Alan Coon, chief resident of radiation oncology at Rush and primary author on the study. "In addition to finding decreases in effusivity of the treated areas many days before the development of skin reactions, we have also seen that the magnitude of these decreases varies with the grade of the reactions. This exciting result bodes well for the clinical utility of this technique in predicting the severity of a skin reaction before it occurs."
In addition, researchers note that 3DTT techniques can be used to measure these tissue property changes non-invasively with no interruption of therapy and the technique allowed for rapid feedback.
"3DTT may also be used to detect other skin diseases such as skin cancer and measure skin damage caused by electricity or lightening. Such applications require the determinations of tissue conditions below the skin that is normally not visible but can be measured by 3DTT", stated J.G. Sun, a mechanical engineer at Argonne.
Researchers plan to perform additional studies to confirm the preliminary results and hope to soon begin studying 3DTT in breast cancer patients. The investigators on the project include Dr. Katherine Griem, James Chu, PhD; Dr. Alan Coon; Damian Bernard, PhD; Riu Yao and Alistair Templeton, all from Rush University Medical Center and J.G. Sun from Argonne National Laboratory.
Argonne National Laboratory is committed to development and transferring new technologies that meet industry's goals of improving energy efficiency, reducing wastes and pollution, lowering production costs, and improving productivity. Argonne's industrial research programme, comprised of leading-edge materials research, cost-saving modelling, and unique testing and analysis facilities, is providing solutions to the challenges that face United States manufacturing and processing industries.
Rush University Medical Center, located in Chicago, includes a 674-bed (staffed) hospital; the Johnston R. Bowman Health Center; and Rush University (Rush Medical College, College of Nursing, College of Health Sciences and the Graduate College). Rush's mission is to provide the best possible care for its patients. Educating tomorrow's health care professional, researching new and more advanced treatment options, transforming the facilities and investing in new technologies - all are undertaken with the drive to improve patient care now, and for the future.