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Tissue viability imaging (TiVi) in the assessment of divergent beam UV-B provocation

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Abstract

In routine clinical phototesting and in basic research, naked eye dermatological assessment is the “gold standard” for determining the patient’s minimal erythemal dose (MED). In UV-B testing with a divergent, radially attenuating beam of characterised dosimetry, laser Doppler perfusion imaging has been previously used to give quantitative description of reactivity to doses above the MED in addition to a “single-dose” objective determination of the MED itself. In the present paper, the recently developed tissue viability imaging (TiVi) technology is presented for the first time as a reliable, easily applicable, high-resolution alternative to LDPI in the divergent beam testing concept. Data obtained after provocation with a range of doses was analysed in order to determine the reaction diameter, which can be related to the MED using field dosimetry. The dose–response features of exposure above the MED and the relationship between naked eye readings and the diameter were determined from the image data. TiVi data were obtained faster than LDPI data and at a higher spatial resolution of 100 μm instead of 1 mm. A tool was developed to centre over the erythema area of the acquired image. Response data could be plotted continuously against dose. Thresholding of processed images compared to naked eye “gold standard” readings showed that the normal skin value +4 standard deviations produced a good fit between both methods. A linear fitting method for the dose–response data provided a further method of determination of the reaction diameter (MED). Erythemal “volume under the surface (VUS)” for the reaction provided a new concept for visualising information. TiVi offers advantages over LDPI in the acquisition and analysis of data collected during divergent beam testing. An increased amount of data compared to traditional phototesting is easily and more objectively obtained which increases applicability in the clinical and research environment.

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Acknowledgments

The authors acknowledge the work of the “Beam Team” Mikael Ilias, Magnus Falk, Karin Wårdell and Marcus Skogh, the dermatologist who first suggested that a radially attenuated field of provocation might provide information which was descriptive for the individual’s reactivity to ultraviolet light. Support to the divergen beam project has been given by the Medical Research Council of Southeast Sweden. The authors would like to acknowledge the support of the IRCSET (Irish Research Council for Science, Engineering & Technology) for funding this project. This research was also supported by the National Biophotonics Imaging Platform (NBIP) Ireland funded under the Higher Education Authority PRTLI Cycle 4, co-funded by the Irish Government and the European Union—Investing in your future. The authors GEN and CDA have roles in the commercialisation of the polarisation spectroscopy instrumentation.

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Authors and Affiliations

  1. Department of Medical Physics, Royal Surrey County Hospital, Guildford, GU2 7XX, United Kingdom

    Jim O’Doherty

  2. Department of Physics, University of Limerick, National Technology Park, Limerick, Ireland

    Jim O’Doherty, Joey Enfield & Martin J. Leahy

  3. Allergy Centre, University Hospital, Linköping University, 581-85, Linköping, Sweden

    Joakim Henricson & Gert E. Nilsson

  4. Wheelsbridge AB, 13 Lövsbersvägen, 589-37, Linköping, Sweden

    Gert E. Nilsson

  5. Division of Dermatology, Department of Clinical and Experimental Medicine, Linköping University, 581-85, Linköping, Sweden

    Chris D. Anderson

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  1. Jim O’Doherty
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  2. Joakim Henricson
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  3. Joey Enfield
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  4. Gert E. Nilsson
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  5. Martin J. Leahy
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  6. Chris D. Anderson
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Correspondence to Chris D. Anderson.

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O’Doherty, J., Henricson, J., Enfield, J. et al. Tissue viability imaging (TiVi) in the assessment of divergent beam UV-B provocation. Arch Dermatol Res 303, 79–87 (2011). https://doi.org/10.1007/s00403-010-1055-2

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  • DOI: https://doi.org/10.1007/s00403-010-1055-2

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