Radiation-therapy-induced erythema: comparison of spectroscopic diffuse reflectance measurements and visual assessment

Surveillance and assessment of radiation-induced erythema is an important aspect of managing skin toxicity in radiation therapy treated patients. Upon receiving the early fractions of radiation, an inflammatory response and vascular dilation takes place due to damage of basal cells in the skin’s epidermal layer. This process of skin reddening known as erythema. The gold standard used for assessing and grading erythema is visual assessment (VA) by an experienced clinician/ radiotherapist using toxicity scoring tools. This method is limited by the assessor’s experience, vision acuity, and the subjectivity of qualitative scores. An alternative optical technique to VA, is diffuse reflectance spectroscopy (DRS). A comparison between both techniques performance in detecting radiation therapy-induced erythema is demonstrated in this pilot study. The results evidenced that DRS is capable of detecting skin erythema before an expert eye could do so.