{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:27:16Z","timestamp":1777872436888,"version":"3.51.4"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["NRF- 2017R1D1A1B03036093"],"award-info":[{"award-number":["NRF- 2017R1D1A1B03036093"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Korea government","award":["No. RS-2023-00253604"],"award-info":[{"award-number":["No. RS-2023-00253604"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>We applied a radiomics approach to skin surface images to objectively assess acute radiation dermatitis in patients undergoing radiotherapy for breast cancer.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A prospective cohort study of 20 patients was conducted. Skin surface images in normal, polarized, and ultraviolet (UV) modes were acquired using a skin analysis device before starting radiotherapy (\u2018Before RT\u2019), approximately 7 days after the first treatment (\u2019RT D7\u2019), on \u2018RT D14\u2019, and approximately 10 days after the radiotherapy ended (\u2018After RT D10\u2019). Eighteen types of radiomic feature ratios were calculated based on the values acquired \u2018Before RT\u2019. We measured skin doses in ipsilateral breasts using optically stimulated luminescent dosimeters on the first day of radiotherapy. Clinical evaluation of acute radiation dermatitis was performed using the Radiation Therapy Oncology Group scoring criteria on \u2018RT D14\u2019 and \u2018After RT D10\u2019. Several statistical analysis methods were used in this study to test the performance of radiomic features as indicators of radiodermatitis evaluation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>As the skin was damaged by radiation, the <jats:italic>energy<\/jats:italic> for normal mode and <jats:italic>sum variance<\/jats:italic> for polarized and UV modes decreased significantly for ipsilateral breasts, whereas contralateral breasts exhibited a smaller decrease with statistical significance. The radiomic feature ratios at \u2018RT D7\u2019 had strong correlations to skin doses and those at \u2018RT D14\u2019 and \u2018after RT D10\u2019 with statistical significance.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The <jats:italic>energy<\/jats:italic> for normal mode and <jats:italic>sum variance<\/jats:italic> for polarized and UV modes demonstrated the potential to evaluate and predict acute radiation, which assists in its appropriate management.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0293071","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T17:28:33Z","timestamp":1698341313000},"page":"e0293071","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Quantitative radiomics approach to assess acute radiation dermatitis in breast cancer patients"],"prefix":"10.1371","volume":"18","author":[{"given":"So-Yeon","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Min","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-in","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Heon","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8578-9976","authenticated-orcid":true,"given":"Minsoo","family":"Chun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Hyun","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7918-1072","authenticated-orcid":true,"given":"Jin 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patients","volume":"20","author":"JB Schnur","year":"2011","journal-title":"Psycho-Oncol"},{"issue":"3","key":"pone.0293071.ref004","doi-asserted-by":"crossref","first-page":"124","DOI":"10.14316\/pmp.2020.31.3.124","article-title":"History of radiation therapy technology.","volume":"31","author":"DH Huh","year":"2020","journal-title":"Prog Med Phys"},{"issue":"3","key":"pone.0293071.ref005","doi-asserted-by":"crossref","first-page":"181","DOI":"10.3857\/roj.2020.00094","article-title":"The effect of deep inspiration breath-hold technique on left anterior descending coronary artery and heart dose in left breast irradiation","volume":"38","author":"P Sakyanun","year":"2020","journal-title":"Radiat Oncol J"},{"issue":"5","key":"pone.0293071.ref006","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/00129334-200209000-00007","article-title":"Wound care after radiation therapy.","volume":"15","author":"FA Mendelsohn","year":"2002","journal-title":"Adv Skin Wound Care"},{"issue":"1","key":"pone.0293071.ref007","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13014-019-1215-2","article-title":"A scoring system predicting acute radiation dermatitis in patients with head and neck cancer treated with intensity-modulated radiotherapy","volume":"14","author":"M Kawamura","year":"2019","journal-title":"Radiat Oncol"},{"issue":"2","key":"pone.0293071.ref008","doi-asserted-by":"crossref","first-page":"69","DOI":"10.14407\/jrpr.2020.45.2.69","article-title":"Organ dose conversion coefficients calculated for Korean pediatric and adult voxel phantoms exposed to external photon fields.","volume":"45","author":"C Lee","year":"2020","journal-title":"J Radiat Prot Res"},{"issue":"4","key":"pone.0293071.ref009","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3747\/co.v17i4.493","article-title":"Prophylaxis and management of acute radiation-induced skin reactions: a systematic review of the literature.","volume":"17","author":"N Salvo","year":"2010","journal-title":"Curr Oncol."},{"issue":"3","key":"pone.0293071.ref010","first-page":"353","article-title":"The impact of treatment interruptions on locoregional control during postoperative breast irradiation. Journal of BUON","volume":"12","author":"NS Bese","year":"2007","journal-title":"J BUON"},{"issue":"2","key":"pone.0293071.ref011","doi-asserted-by":"crossref","first-page":"109","DOI":"10.3857\/roj.2020.00129","article-title":"Late-term effects of hypofractionated chest wall and regional nodal radiotherapy with two-dimensional technique in patients with breast cancer","volume":"38","author":"BS Yadav","year":"2020","journal-title":"Radiat Oncol J"},{"issue":"1","key":"pone.0293071.ref012","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3857\/roj.2019.00647","article-title":"Regional nodal irradiation in pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation","volume":"38","author":"S Park","year":"2020","journal-title":"Radiat Oncol J"},{"issue":"4","key":"pone.0293071.ref013","doi-asserted-by":"crossref","first-page":"259","DOI":"10.3857\/roj.2019.00052","article-title":"Daily localization of partial breast irradiation patients with three-dimensional ultrasound imaging.","volume":"37","author":"M Sayan","year":"2019","journal-title":"Radiat Oncol J"},{"issue":"2","key":"pone.0293071.ref014","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3857\/roj.2018.00451","article-title":"Radiotherapy for initial clinically positive internal mammary nodes in breast cancer","volume":"37","author":"J Kim","year":"2019","journal-title":"Radiat Oncol J"},{"issue":"6","key":"pone.0293071.ref015","first-page":"907","article-title":"Early and late radiation-induced skin alterations. Part II: Nursing care of irradiated skin","volume":"19","author":"E Sitton","year":"1992","journal-title":"Oncol Nurs Forum."},{"issue":"1","key":"pone.0293071.ref016","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/s13014-017-0940-7","article-title":"Significant suppression of radiation dermatitis in breast cancer patients using a topically applied adrenergic vasoconstrictor","volume":"12","author":"JF Cleary","year":"2017","journal-title":"Radiat Oncol"},{"issue":"3","key":"pone.0293071.ref017","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1046\/j.1365-2354.1999.00153.x","article-title":"Skin reactions during radiotherapy for breast cancer: the use and impact of topical agents and dressings","volume":"8","author":"D Porock","year":"1999","journal-title":"Eur J Cancer Care"},{"issue":"4","key":"pone.0293071.ref018","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1188\/06.CJON.487-492","article-title":"The validity of skin care protocols followed by women with breast cancer receiving external radiation","volume":"10","author":"J. Aistars","year":"2006","journal-title":"Clin J Oncol Nurs"},{"issue":"8","key":"pone.0293071.ref019","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s11604-009-0345-0","article-title":"Longitudinal practical measurement of skin color and moisture during and after breast-conserving therapy: influence of neoadjuvant systemic therapy.","volume":"27","author":"H Yamazaki","year":"2009","journal-title":"Jpn J Radiol"},{"issue":"5","key":"pone.0293071.ref020","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/0360-3016(95)00060-C","article-title":"Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC).","volume":"31","author":"JD Cox","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"pone.0293071.ref021","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S1053-4296(05)80038-4","article-title":"The Uniform Reporting of Treatment-Related Morbidity.","volume":"4","author":"S. Dische","year":"1994","journal-title":"Semin Radiat Oncol."},{"issue":"3","key":"pone.0293071.ref022","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S1053-4296(03)00031-6","article-title":"CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment","volume":"13","author":"A Trotti","year":"2003","journal-title":"Semin Radiat Oncol"},{"issue":"2","key":"pone.0293071.ref023","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.ijrobp.2010.05.065","article-title":"Comparison of provider-assessed and patient-reported outcome measures of acute skin toxicity during a Phase III trial of mometasone cream versus placebo during breast radiotherapy: the North Central Cancer Treatment Group (N06C4).","volume":"81","author":"MA Neben-Wittich","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"pone.0293071.ref024","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6","article-title":"Reporting results of cancer treatment","volume":"47","author":"AB Miller","year":"1981","journal-title":"Cancer"},{"issue":"1","key":"pone.0293071.ref025","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.ijrobp.2004.04.047","article-title":"Randomized trial on two types of thermoplastic masks for patient immobilization during radiation therapy for head-and-neck cancer","volume":"61","author":"L Sharp","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"18","key":"pone.0293071.ref026","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.1016\/j.ejca.2011.06.039","article-title":"Frequency and severity of skin reactions in patients with breast cancer undergoing adjuvant radiotherapy, the usefulness of two assessment instruments\u2014a pilot study","volume":"47","author":"L Sharp","year":"2011","journal-title":"Eur J Cancer"},{"issue":"6","key":"pone.0293071.ref027","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/s00066-005-1345-3","article-title":"Spectrophotometric skin measurements correlate with EORTC\/RTOG-common toxicity criteria.","volume":"181","author":"F Momm","year":"2005","journal-title":"Strahlenther Onkol."},{"issue":"11","key":"pone.0293071.ref028","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s00066-010-2134-1","article-title":"Objective assessment of dermatitis following post-operative radiotherapy in patients with breast cancer treated with breast-conserving treatment","volume":"186","author":"K Yoshida","year":"2010","journal-title":"Strahlenther Onkol"},{"issue":"12","key":"pone.0293071.ref029","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1111\/1346-8138.12669","article-title":"Changes in biophysical properties of the skin following radiotherapy for breast cancer","volume":"41","author":"SC Hu","year":"2014","journal-title":"J Dermatol"},{"issue":"1","key":"pone.0293071.ref030","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.radonc.2016.09.019","article-title":"Evaluation of acute skin toxicity in breast radiotherapy with a new quantitative approach.","volume":"122","author":"A Gonzalez Sanchis","year":"2017","journal-title":"Radiother Oncol."},{"key":"pone.0293071.ref031","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.radonc.2020.02.018","article-title":"Acute radiation-induced skin toxicity in hypofractionated vs. conventional whole-breast irradiation: An objective, randomized multicenter assessment using spectrophotometry","volume":"146","author":"LC Schmeel","year":"2020","journal-title":"Radiother Oncol"},{"key":"pone.0293071.ref032","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1126\/scitranslmed.aaa7582","article-title":"Magnetic resonance image features identify glioblastoma phenotypic subtypes with distinct molecular pathway activities.","volume":"7","author":"H Itakura","year":"2015","journal-title":"Sci Transl Med"},{"key":"pone.0293071.ref033","doi-asserted-by":"crossref","first-page":"108991","DOI":"10.1016\/j.ejrad.2020.108991","article-title":"A review of original articles published in the emerging field of radiomics.","volume":"127","author":"J Song","year":"2020","journal-title":"Eur J Radiol"},{"issue":"5","key":"pone.0293071.ref034","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.ijrobp.2019.12.032","article-title":"Quantitative Thermal Imaging Biomarkers to Detect Acute Skin Toxicity From Breast Radiation Therapy Using Supervised Machine Learning","volume":"106","author":"K Saednia","year":"2020","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"pone.0293071.ref035","first-page":"1204","article-title":"Thermography based breast cancer detection using texture features and minimum variance quantization.","volume":"13","author":"M Milosevic","year":"2014","journal-title":"EXCLI J."},{"issue":"6","key":"pone.0293071.ref036","doi-asserted-by":"crossref","first-page":"e0218018","DOI":"10.1371\/journal.pone.0218018","article-title":"Testing the feasibility of augmented digital skin imaging to objectively compare the efficacy of topical treatments for radiodermatitis.","volume":"14","author":"R Partl","year":"2019","journal-title":"PloS one."},{"key":"pone.0293071.ref037","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ejmp.2017.05.057","article-title":"Sensitivity and stability of optically stimulated luminescence dosimeters with filled deep electron\/hole traps under pre-irradiation and bleaching conditions","volume":"38","author":"SY Park","year":"2017","journal-title":"Phys Med"},{"key":"pone.0293071.ref038","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1118\/1.598691","article-title":"AAPM\u2019s TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams.","volume":"26","author":"PR Almond","year":"1999","journal-title":"Med Phys"},{"issue":"6","key":"pone.0293071.ref039","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1109\/TSMC.1973.4309314","article-title":"Textural Features for Image Classification","volume":"3","author":"RM Haralick","year":"1973","journal-title":"IEEE Trans Syst Man Cybern"},{"key":"pone.0293071.ref040","unstructured":"MathWorks. File Exchange. https:\/\/kr.mathworks.com\/matlabcentral\/fileexchange\/22354-glcm_features4-m-vectorized-version-of-glcm_features1-m-with-code-changes?s_tid=srchtitle. 2010. [accessed 8 December 2008]."},{"issue":"1","key":"pone.0293071.ref041","doi-asserted-by":"crossref","first-page":"12306","DOI":"10.1038\/s41598-018-30710-4","article-title":"Comparison of radiation dermatitis between hypofractionated and conventionally fractionated postoperative radiotherapy: objective, longitudinal assessment of skin color.","volume":"8","author":"H Yamazaki","year":"2018","journal-title":"Sci Rep."},{"issue":"2","key":"pone.0293071.ref042","first-page":"127","article-title":"Chen YR. Co-occurrence matrix texture features of multi-spectral images on poultry Carcasses","volume":"78","author":"B. Park","year":"2001","journal-title":"Engng Res"},{"issue":"3","key":"pone.0293071.ref043","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.breast.2015.01.008","article-title":"RTOG, CTCAE and WHO criteria for acute radiation dermatitis correlate with cutaneous blood flow measurements","volume":"24","author":"CJ Huang","year":"2015","journal-title":"Breast"},{"issue":"3","key":"pone.0293071.ref044","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.ijrobp.2008.08.071","article-title":"Breast intensity-modulated radiation therapy reduces time spent with acute dermatitis for women of all breast sizes during radiation","volume":"74","author":"GM Freedman","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"pone.0293071.ref045","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/01.coc.0000197661.09628.03","article-title":"Intensity modulated radiation therapy (IMRT) decreases acute skin toxicity for women receiving radiation for breast cancer","volume":"29","author":"GM Freedman","year":"2006","journal-title":"Am J Clin Oncol"},{"issue":"3","key":"pone.0293071.ref046","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3892\/mco.2021.2355","article-title":"New field\u2011in\u2011field with two reference points method for whole breast radiotherapy: Dosimetric analysis and radiation\u2011induced skin toxicities assessment.","volume":"15","author":"N Tekiki","year":"2020","journal-title":"Mol Clin Oncol"},{"issue":"4","key":"pone.0293071.ref047","doi-asserted-by":"crossref","first-page":"315","DOI":"10.3857\/roj.2020.00395","article-title":"Clinical factors affecting the determination of radiotherapy-induced skin toxicity in breast cancer","volume":"39","author":"EE Cordoba","year":"2021","journal-title":"Radiat Oncol J"},{"issue":"6","key":"pone.0293071.ref048","first-page":"563","article-title":"Recent Perspectives on Oncoplastic Breast Surgery in Korea.","volume":"30","author":"T. Kang","year":"2020","journal-title":"J Life Sci"},{"issue":"6","key":"pone.0293071.ref049","doi-asserted-by":"crossref","first-page":"e 0128544","DOI":"10.1371\/journal.pone.0128544","article-title":"On the use of optically stimulated luminescent dosimeter for surface dose measurement during radiotherapy.","volume":"10","author":"FH Yusof","year":"2015","journal-title":"PloS one."},{"issue":"2","key":"pone.0293071.ref050","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.ijrobp.2014.06.042","article-title":"Racial variations in radiation-induced skin toxicity severity: data from a prospective cohort receiving postmastectomy Radiation","volume":"90","author":"JL Wright","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"pone.0293071.ref051","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1148\/radiol.2020191145","article-title":"The Image Biomarker Standardization Initiative: Standardized Quantitative Radiomics for High-Throughput Image-based Phenotyping.","volume":"295","author":"A Zwanenburg","year":"2020","journal-title":"Radiology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0293071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T17:29:29Z","timestamp":1698341369000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0293071"}},"subtitle":[],"editor":[{"given":"Daniele Ugo","family":"Tari","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,10,26]]},"references-count":51,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0293071","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,26]]}}}