University of Oulu

Myllylä, T., Korhonen, V., Karthikeyan, P., Honka, U., Lohela, J., Inget, K., Ferdinando, H., Karhula, S. S., & Nikkinen, J. (2023). Cerebral tissue oxygenation response to brain irradiation measured during clinical radiotherapy. Journal of Biomedical Optics, 28(01).

Cerebral tissue oxygenation response to brain irradiation measured during clinical radiotherapy

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Author: Myllylä, Teemu1,2; Korhonen, Vesa1,3,4; Karthikeyan, Priya1;
Organizations: 1University of Oulu, Research Unit of Health Sciences and Technology, Oulu, Finland
2University of Oulu, Optoelectronics and Measurement Techniques Unit, Oulu, Finland
3Oulu University Hospital, Department of Diagnostic Radiology, Oulu, Finland
4Medical Research Center, Oulu, Finland
5Oulu University Hospital, Department of Oncology and Radiotherapy, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 4.2 MB)
Persistent link:
Language: English
Published: SPIE, 2023
Publish Date: 2023-08-23


Significance: Cancer therapy treatments produce extensive changes in the physiological and morphological properties of tissues, which are also individual dependent. Currently, a key challenge involves developing more tailored cancer therapy, and consequently, individual biological response measurement during therapy, such as tumor hypoxia, is of high interest. This is the first time human cerebral haemodynamics and cerebral tissue oxygenation index (TOI) changes were measured during the irradiation in clinical radiotherapy and functional near-infrared spectroscopy (fNIRS) technique was demonstrated as a feasible technique for clinical use in radiotherapy, based on 34 online patient measurements.

Aim: Our aim is to develop predictive biomarkers and noninvasive real-time methods to establish the effect of radiotherapy during treatment as well as to optimize radiotherapy dose planning for individual patients. In particular, fNIRS-based technique could offer an effective and clinically feasible online technique for continuous monitoring of brain tissue hypoxia and responses to chemo- and radiotherapy, which involves modulating tumor oxygenation to increase or decrease tumor hypoxia. We aim to show that fNIRS is feasible for repeatability measuring in patient radiotherapy, the temporal alterations of tissue oxygenation induced by radiation.

Approach: Fiber optics setup using multiwavelength fNIRS was built and combined with a medical linear accelerator to measure cerebral tissue oxygenation changes during the whole-brain radiotherapy treatment, where the radiation dose is given in whole brain area only preventing dosage to eyes. Correlation of temporal alterations in cerebral haemodynamics and TOI response to brain irradiation was quantified.

Results: Online fNIRS patient measurement of cerebral haemodynamics during clinical brain radiotherapy is feasible in clinical environment, and results based on 34 patient measurements show strong temporal alterations in cerebral haemodynamics and decrease in TOI during brain irradiation and confirmed the repeatability. Our proof-of-concept study shows evidently that irradiation causes characteristic immediate changes in brain tissue oxygenation.

Conclusions: In particular, TOI seems to be a sensitive parameter to observe the tissue effects of radiotherapy. Monitoring the real-time interactions between the subjected radiation dose and corresponding haemodynamic effects may provide important tool for the researchers and clinicians in the field of radiotherapy. Eventually, presented fNIRS technique could be used for improving dose planning and safety control for individual patients.

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Series: Journal of biomedical optics
ISSN: 1083-3668
ISSN-E: 1560-2281
ISSN-L: 1083-3668
Volume: 28
Issue: 1
Article number: 015002
DOI: 10.1117/1.JBO.28.1.015002
Type of Publication: A1 Journal article – refereed
Field of Science: 217 Medical engineering
Funding: This work was supported by Academy of Finland (grant 318347).
Academy of Finland Grant Number: 318347
Detailed Information: 318347 (Academy of Finland Funding decision)
Copyright information: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI. [DOI: 10.1117/1.JBO.28.1.015002]