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Multivariate non-invasive measurements of skin disorders
Umeå University, Faculty of Science and Technology, Department of Chemistry.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present thesis proposes new methods for obtaining objective and accurate diagnoses in modern healthcare. Non-invasive techniques have been used to examine or diagnose three different medical conditions, namely neuropathy among diabetics, radiotherapy induced erythema (skin redness) among breast cancer patients and diagnoses of cutaneous malignant melanoma. The techniques used were Near-InfraRed spectroscopy (NIR), Multi Frequency Bio Impedance Analysis of whole body (MFBIA-body), Laser Doppler Imaging (LDI) and Digital Colour Photography (DCP).

The neuropathy for diabetics was studied in papers I and II. The first study was performed on diabetics and control subjects of both genders. A separation was seen between males and females and therefore the data had to be divided in order to obtain good models. NIR spectroscopy was shown to be a viable technique for measuring neuropathy once the division according to gender was made. The second study on diabetics, where MFBIA-body was added to the analysis, was performed on males exclusively. Principal component analysis showed that healthy reference subjects tend to separate from diabetics. Also, diabetics with severe neuropathy separate from persons less affected.

The preliminary study presented in paper III was performed on breast cancer patients in order to investigate if NIR, LDI and DCP were able to detect radiotherapy induced erythema. The promising results in the preliminary study motivated a new and larger study. This study, presented in papers IV and V, intended to investigate the measurement techniques further but also to examine the effect that two different skin lotions, Essex and Aloe vera have on the development of erythema. The Wilcoxon signed rank sum test showed that DCP and NIR could detect erythema, which is developed during one week of radiation treatment. LDI was able to detect erythema developed during two weeks of treatment. None of the techniques could detect any differences between the two lotions regarding the development of erythema.

The use of NIR to diagnose cutaneous malignant melanoma is presented as unpublished results in this thesis. This study gave promising but inconclusive results. NIR could be of interest for future development of instrumentation for diagnosis of skin cancer.

Place, publisher, year, edition, pages
Umeå: Kemi , 2006. , 46 p.
Keyword [en]
Multivariate Data Analysis, Non-invasive techniques, Clinical studies, Principal Component Analysis, Partial Least Squares Discriminant Analysis, Wilcoxon Signed Rank Sum Test, Near-InfraRed spectroscopy, Frequency Bio Impedance Analysis of whole body, Laser Doppler Imaging, Digital Colour Photography
National Category
Analytical Chemistry
Identifiers
URN: urn:nbn:se:umu:diva-865ISBN: 91-7264-154-1 (print)OAI: oai:DiVA.org:umu-865DiVA: diva2:144792
Public defence
2006-10-06, KB3A9, KBC-huset, Umeå, 10:30
Opponent
Supervisors
Available from: 2006-09-14 Created: 2006-09-14 Last updated: 2017-01-18Bibliographically approved
List of papers
1. A multivariate NIR study of skin alterations in diabetic patients as compared to control subjects
Open this publication in new window or tab >>A multivariate NIR study of skin alterations in diabetic patients as compared to control subjects
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2000 (English)In: Journal of Near Infrared Spectroscopy, ISSN 0967-0335, Vol. 8, no 4, 217-227 p.Article in journal (Refereed) Published
Abstract [en]

A group of 15 diabetic persons with different degrees of diabetes complications, including skin changes, was studied by Fourier Transform Near Infrared (FT-NIR) spectroscopy. Skin reflectance spectra were measured with a fibre-optic probe in four locations (sites): hand, arm, leg and foot. For reference, a group of 28 healthy controls was also measured. Multivariate analysis of the NIR spectra obtained shows a high potential for classification and discrimination of the skin conditions. Valuable indications for future experiments can be observed.

Keyword
FT-NIR, fibre-optic probe, PCA, PLS-DA, skin changes, diabetes
Identifiers
urn:nbn:se:umu:diva-9168 (URN)
Available from: 2008-03-06 Created: 2008-03-06 Last updated: 2010-10-26Bibliographically approved
2. Combined near-infrared spectroscopy and multifrequency bio-impedance investigation of skin alterations in diabetes patients based on multivariate analyses
Open this publication in new window or tab >>Combined near-infrared spectroscopy and multifrequency bio-impedance investigation of skin alterations in diabetes patients based on multivariate analyses
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2003 (English)In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 41, no 3, 324-329 p.Article in journal (Refereed) Published
Abstract [en]

A group of 34 diabetic men, with different degrees of diabetes complications, including skin changes, were studied by near-infrared (NIR) spectroscopy and total body multi-frequency bio-impedance analyses (MFBIA-body). Skin reflectance spectra were measured with a fibre-optic probe in four locations (sites): hand, arm, leg and foot. As control subjects, a group of 23 healthy males were also measured. A combined multivariate analysis of the two types of spectrum was performed. It was concluded that the NIR method has the potential to detect diabetes-related skin conditions and also that the combination of the two techniques provides a higher potential for classification and discrimination of the skin conditions, with correct classification increasing from 63% to 85%.

Place, publisher, year, edition, pages
Springer, 2003
Keyword
NIR, Total body bio-impedance, Fibre-optic probe, PCA, Skin changes, Diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-9916 (URN)10.1007/BF02348438 (DOI)
Available from: 2008-05-22 Created: 2008-05-22 Last updated: 2012-06-26Bibliographically approved
3. Objective measurements of radiotherapy-induced erythema
Open this publication in new window or tab >>Objective measurements of radiotherapy-induced erythema
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2004 (English)In: Skin research and technology, ISSN 0909-752X, E-ISSN 1600-0846, Vol. 10, no 4, 242-250 p.Article in journal (Refereed) Published
Abstract [en]

Background/aims: The development of acute radiation erythema is a common phenomenon among patients undergoing radiotherapy treatment. Because of the absence of reliable objective classification methods, the degree of skin reaction can at present mainly be judged subjectively in the clinic. This has motivated the present preliminary study, concerning the first steps in the development of an objective method for skin reaction classification.

Methods: Three non-invasive techniques were used: near-infrared (NIR) spectroscopy, laser Doppler perfusion imaging and digital photography. The NIR spectra were analysed with principal component analysis (PCA), and the results from the other two with traditional univariate methods. Measurements were made on breast cancer patients who had been exposed to different irradiation doses. A total of 28 breast cancer patients participated one to three times each; 12 were treated with photons at 4 or 6 MeV and 16 were treated with high-energy electrons between 10 and 20 MeV to a maximum dose of 50 Gy.

Results: PCA of NIR spectra shows that information on radiation dose lies mainly in the first principal component. It is observed that the higher the dose the higher the score value. The results from the laser Doppler measurements show that in 79% of the cases the perfusion increases significantly with radiation dose. Analysis of the digital photography shows that a proposed skin redness index (SRI), increases with a higher radiation dose. However, the increase in most cases is not significant. By combining all data, correlation to radiation doses was seen for 74% of the patients who participated more than once.

Conclusion: All three non-invasive methods correlate with the radiation dose but to various degrees. NIR spectroscopy, laser Doppler and a combination of the three techniques are the most promising methods for characterising erythema

Place, publisher, year, edition, pages
Copenhagen: Munksgaard, 2004
Keyword
breast cancer, digital photography, image analysis, laser Doppler, near-infrared spectroscopy, PCA, radiation treatment
Identifiers
urn:nbn:se:umu:diva-15526 (URN)doi:10.1111/j.1600-0846.2004.00078.x (DOI)
Available from: 2007-04-23 Created: 2007-04-23 Last updated: 2011-03-07Bibliographically approved
4. Objective measurement of Radiation Induced Erythema by nonparametric hypothesis testing on indices from multivariate data
Open this publication in new window or tab >>Objective measurement of Radiation Induced Erythema by nonparametric hypothesis testing on indices from multivariate data
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2008 (English)In: Chemometrics and Intelligent Laboratory Systems, Vol. 90, no 1, 43-8 p.Article in journal (Refereed) Published
Abstract [en]

Three instrumental measurement techniques: Laser-Doppler Imaging (LDI), Digital Colour Photography (DCP) and Near InfraRed (NIR) spectroscopy were tested for their potential to objectively measure radiation-based erythema in breast cancer patients. The irradiation dose intervals were 0, 8-16, 18-26, 28-34, 36-44 and 46-50 Gy. In addition, two types of skin lotion for reducing erythema were tested on the patients and these were compared to using no lotion. The measured results had very skew distributions for all three techniques making nonparametric testing necessary. The Wilcoxon Signed Rank Sum Test (WSRST) was used for this purpose. LDI was performed to produce univariate average perfusion values leading to a perfusion increment ratio. These ratios showed a good sensitivity to erythema, with a median detection limit of 18 Gy. DCP was used to extract average red-green-blue (RGB) values that were used in multivariate models. Results for a combination of principal component score values showed a marked increase in median erythema from 8 Gy on. The Multivariate data from NIR spectroscopy were data-reduced to principal component scores and combinations of these were tested. The score combinations were used to show median detection limits down to 8 Gy. The difference between the lotions and using no lotion gave no significant result for the WSRST paired comparison for any used measurement technique.

Keyword
objective erythema measurement, multivariate data analysis, Wilcoxon nonparametric test, skin lotion, instrumentation
Identifiers
urn:nbn:se:umu:diva-16195 (URN)doi:10.1016/j.chemolab.2007.08.005 (DOI)
Note
15 January 2008Available from: 2007-12-10 Created: 2007-12-10 Last updated: 2011-02-24Bibliographically approved
5. Comparison of three instrumental methods for the objective evaluation of radiotherapy induced erythema in breast cancer patients and a study of the effect of skin lotions
Open this publication in new window or tab >>Comparison of three instrumental methods for the objective evaluation of radiotherapy induced erythema in breast cancer patients and a study of the effect of skin lotions
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2007 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 46, no 7, 893-899 p.Article in journal (Refereed) Published
Abstract [en]

A non-blinded three armed study of the effect of Aloe vera, Essex and no lotion on erythema was performed. The erythema is an effect of radiotherapy treatment in breast cancer patients. The study required testing of objective methods for measuring the erythema. The chosen experimental methods were Near Infrared Spectroscopy, Laser Doppler Imaging and Digital Colour Photography. The experimental setup was made in such a way that in parallel with testing the effect of the lotions there was also a test of the sensitivity of the instruments. Fifty women were selected consecutively to participate in the study. They were all subjected to treatment with high-energy electrons (9-20 MeV) after mastectomy, 2Gy/day to a total dose of 50 Gy. Measurements were performed before the start of radiotherapy and thereafter once a week during the course of treatment. Aloe vera and Essex lotion were applied twice every radiation day in selected sites. The increase in skin redness could be monitored with all techniques with a detection limit of 8 Gy for Digital Colour Photography and Near Infrared Spectroscopy and 18 Gy for Laser Doppler Imaging. In clinical practice our recommendation is to use Digital Colour Photography. No significant median differences were observed between the pairs no lotion-Essex, no lotion-Aloe vera and Essex-Aloe vera for any of the techniques tested.

Place, publisher, year, edition, pages
Oslo: Taylor & Francis, 2007
Keyword
Aloe-vera gel, double-blind, radiation dermatitis, phase-III, cream, therapy, tissue
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-16795 (URN)10.1080/02841860701 (DOI)000249872900002 ()17917821 (PubMedID)
Available from: 2007-11-20 Created: 2007-11-20 Last updated: 2017-01-18Bibliographically approved

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