Optical Coherence Tomography for Quantifying Human Cutaneous Chronic Graft-versus-Host Disease
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Published on: October 21, 2022
George L Chen1, Mansik Jeon2, Maureen Ross1
1Department of Medicine, Transplant and Cellular Therapy Program, Roswell Park Cancer Institute, Buffalo, New York.
Insights
Optical coherence tomography (OCT) noninvasively measures skin changes in chronic graft-versus-host disease (cGVHD). OCT imaging correlates with cGVHD severity and can track treatment response, aiding clinical trials.
Area of Science:
- Biomedical Engineering
- Dermatology
- Oncology
Background:
- Chronic graft-versus-host disease (cGVHD) is a major cause of mortality post-allogeneic hematopoietic cell transplantation (alloHCT).
- Cutaneous cGVHD presents as skin thickening and reduced mobility, currently assessed via subjective physical examination.
- Objective, quantitative methods are needed for cGVHD assessment.
Purpose of the Study:
- To evaluate the applicability of Optical Coherence Tomography (OCT) for assessing human cutaneous cGVHD.
- To correlate OCT imaging parameters with clinical severity of cutaneous cGVHD.
- To determine if OCT can monitor longitudinal changes during cGVHD treatment.
Main Methods:
- Prospective examination of seven patients with cutaneous cGVHD and three controls using OCT.
- Clinical assessment utilized the cGVHD Skin (Vienna) Scale.
- OCT imaging analyzed parameters like stratum corneum thickness, epidermal thickness, and light transmission depth.
Main Results:
- OCT parameters, including stratum corneum thickness and epidermal thickness, significantly correlated with cutaneous cGVHD severity across multiple body sites (P ≤ .03).
- Longitudinal OCT findings mirrored clinical changes in treated patients.
- OCT detected changes in skin microstructure even when not clinically apparent.
Conclusions:
- OCT is a viable, noninvasive tool for assessing cutaneous cGVHD severity.
- OCT imaging can objectively track disease progression and treatment response.
- OCT may enhance clinical trial design by providing quantitative outcome measures for cGVHD.
Abstract:
Chronic graft-versus-host disease (cGVHD) is the most common cause of nonrelapse mortality after allogeneic hematopoietic cell transplantation (alloHCT). Cutaneous cGVHD is characterized by thickening of the skin and connective tissues, causing discomfort and limited mobility. Current assessment of these skin lesions is based on physical examination of their thickening, pinchability, and movability. Optical coherence tomography (OCT) is a noninvasive, high-resolution technique using near-infrared light to interrogate tissues and image the microstructure without the use of contrast agents. We determined the applicability of OCT to human cutaneous cGVHD. Seven patients with varying degrees of cutaneous cGVHD, including 3 controls who underwent autologous HCT were prospectively examined using the cGVHD Skin (Vienna) Scale and imaged with OCT. Analysis of OCT images and clinical exams revealed that stratum corneum thickness, epidermal thickness, and depth of light transmission were correlated with cutaneous cGVHD severity in the hands, forearms, upper arms, legs, thighs, and upper back (P ≤ .03). Longitudinal OCT changes during cGVHD treatment paralleled clinical changes in the arm and upper back. OCT changes were observed in the absence of clinical changes. OCT imaging reflects the severity of cutaneous cGVHD and can be used to follow these lesions. OCT may facilitate the design of therapeutic trials in cGVHD by providing a quantitative measurement of cGVHD severity. Additional studies are needed.
