In vivo skin dose measurement using MOSkin detectors in tangential breast radiotherapy

Jong, Wei Loong; Ung, Ngie Min; Wong, Jeannie Hsiu Ding; Ng, Kwan Hoong; Ishak, Wan Zamaniah Wan; Malik, Rozita Abdul; Phua, Vincent Chee Ee; Cutajar, D.L.; Metcalfe, Peter E; Rosenfeld, Anatoly B.; Ho, Gwo Fuang

doi:10.1016/j.ejmp.2016.10.022

Cited by 19 publications

(17 citation statements)

References 40 publications

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“…(2016). 28 This dose level was quite tolerable for skin tissue, but the tissue at the exposed site would require time to repair and recover from the daily radiation injury. This study was limited by the small sample size and the lack of in vivo skin dose measurements in EBRT.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The EBRT dose was obtainable only from the treatment planning system, which might be inaccurate for superficial skin dose estimation due to the limitation of the pencil beam convolution dose calculation algorithm. 28,29 The radiation's cumulative damage on skin tissue, coupled with the individual clinical characteristics, may cause some patients to develop grade 1 and 2 skin toxicity at a later stage of treatment. No correlation was observed between skin toxicity and the dose received.…”

Section: Radiation-induced Skin Toxicity Due To Iortmentioning

confidence: 99%

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Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Wong

Zaili

Malik

et al. 2021

J Applied Clin Med Phys

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This study aims to evaluate in vivo skin dose delivered by intraoperative radiotherapy (IORT) and determine the factors associated with an increased risk of radiation-induced skin toxicity.Methodology: A total of 21 breast cancer patients who underwent breastconserving surgery and IORT, either as IORT alone or IORT boost plus external beam radiotherapy (EBRT), were recruited in this prospective study. EBT3 film was calibrated in water and used to measure skin dose during IORT at concentric circles of 5 mm and 40 mm away from the applicator. For patients who also had EBRT, the maximum skin dose was estimated using the radiotherapy treatment planning system. Mid-term skin toxicities were evaluated at 3 and 6 months post-IORT. Results:The average skin dose at 5 mm and 40 mm away from the applicator was 3.07 ± 0.82 Gy and 0.99 ± 0.28 Gy, respectively. Patients treated with IORT boost plus EBRT received an additional skin dose of 41.07 ± 1.57 Gy from the EBRT component. At 3 months post-IORT, 86% of patients showed no evidence of skin toxicity. However, the number of patients suffering from skin toxicity increased from 15% to 38% at 6 months post-IORT. We found no association between the IORT alone or with the IORT boost plus EBRT and skin toxicity. Older age was associated with increased risk of skin toxicities. A mathematical model was derived to predict skin dose. Conclusion:EBT3 film is a suitable dosimeter for in vivo skin dosimetry in IORT, providing patient-specific skin doses. Both IORT alone and IORT boost techniques resulted in similar skin toxicity rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Radiation-induced Skin Toxicity Due To Iortmentioning

confidence: 99%

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Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Wong

Zaili

Malik

et al. 2021

J Applied Clin Med Phys

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“…The majority of studies confirm that non-ionization and non-invasive methods with cell-therapy would affect skin tissue injury. Radiation-induced skin tissue injury, as the most common side effect of radiotherapy methods, interventional radiation therapy, and nuclear events, is being increased with new methods 1 . Reports indicate that ~ 95% of people who receive radiation therapy have experienced acute or chronic skin tissue radiation side effects 2 .…”

Section: Introductionmentioning

confidence: 99%

Low-intensity ultrasound combined with allogenic adipose-derived mesenchymal stem cells (AdMSCs) in radiation-induced skin injury treatment

Moghaddam

Mokhtari‐Dizaji

Nilforoshzadeh

et al. 2020

Sci Rep

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Mesenchymal stem cells are mechano-sensitive cells with the potential to restore the function of damaged tissues. Low-intensity ultrasound has been increasingly considered as a bioactive therapeutic apparatus. Optimizing transplantation conditions is a critical aim for radiation-induced skin tissue injury. Therefore, the therapeutic function of adipose-derived mesenchymal stem cells to ultrasound stimulus was examined based on the mechanical index (MI). Mesenchymal stem cells were isolated from the adipose tissues of mature guinea pigs. An ultrasound system (US) was constructed with a 40 kHz frequency. The radiation-induced skin injury model was produced on the abdominal skin of guinea pigs by 60 Gy of radiation. Then, they were divided to 7 groups (n = 42): control, sham, US (MI = 0.7), AdMSCs injection, US AdMSCs (AdMSCs, under US with MI = 0.2), AdMSCs + US (AdMSCs transplantation and US with MI = 0.7) and US AdMSCs + US (combining the last two groups). The homing of stem cells was verified with fluorescence imaging. The groups were followed with serial photography, ultrasound imaging, tensiometry, and histology. The thickness of the skin was analyzed. Functional changes in skin tissue were evaluated with Young’s modulus (kPa). One-way ANOVA tests were performed to analyze differences between treatment protocols (p < 0.05). The results of Kumar’s score showed that radiation injury was significantly lower in the treatment groups of US AdMSCs and US AdMSCs + US than other groups after 14 days (p < 0.05). There was a significant difference in skin thickness between treatment groups with control, sham, and US groups after 60 Gy radiation and were closer to the thickness of healthy skin. Young’s modulus in US AdMSCs + US, US AdMSCs, and AdMSCs + US groups demonstrated a significant difference with the other groups (p < 0.05). Young’s modulus in US AdMSCs + US and US AdMSCs treatment groups were closer to Young’s modulus of the healthy skin. The histological results confirmed the improvement of acute radiation damage in the combined treatment method, especially in US AdMSCs + US and US AdMSCs groups with increasing the epithelialization and formation of collagen. An ultrasonic treatment plan based on a mechanical index of the target medium could be used to enhance stem cell therapy.

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“…In many applications, it is desired to have a distributed network of miniaturized, solid-state dosimeters that combine a compact, low-power electronic readout and a small and robust design to achieve a spatial map of the deposited dose. In medical scenarios, where radiation doses on human skin or in human organs have to be assessed, flexibility and high integration density of the sensor array are further crucial properties ( 6 , 7 ). Moreover, the possibility of wireless communication would allow the facile integration of a network of sensors over large areas to monitor or detect radiation contamination sources.…”

Section: Introductionmentioning

confidence: 99%

Passive radiofrequency x-ray dosimeter tag based on flexible radiation-sensitive oxide field-effect transistor

et al. 2018

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In vivo skin dose measurement using MOSkin detectors in tangential breast radiotherapy

Cited by 19 publications

References 40 publications

Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Low-intensity ultrasound combined with allogenic adipose-derived mesenchymal stem cells (AdMSCs) in radiation-induced skin injury treatment

Passive radiofrequency x-ray dosimeter tag based on flexible radiation-sensitive oxide field-effect transistor

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