University of Massachusetts Medical School Faculty Publications


Skin perfusion and oxygenation changes in radiation fibrosis

UMMS Affiliation

Department of Radiation Oncology; Department of Surgery, Division of Plastic and Reconstructive Surgery

Publication Date


Document Type



Animals; Fibrosis; Male; Mice; Mice, Hairless; Oxygen; Radiation Injuries; *Regional Blood Flow; Skin


Oncology | Plastic Surgery | Skin and Connective Tissue Diseases


BACKGROUND: Ionizing radiation is known to have deleterious chronic effects on skin, including fibrosis and poor wound healing, hypothesized as mediated by ischemia and hypoxia. Past studies have been unable to simultaneously investigate changes in perfusion and oxygenation as separate parameters. Hyperspectral imaging has emerged as a tool with which to concurrently measure skin perfusion and oxygenation. The authors investigated the use of hyperspectral imaging in a novel murine model of chronic radiation injury.

METHODS: Areas of flank skin (n = 20) on hairless mice were exposed to a 50-Gy dose of beta-radiation. Hyperspectral imaging acquisition was performed at select points through 8 weeks. Immunohistochemical staining and gene expression analysis were performed to evaluate cutaneous vascular density, epidermal cell hypoxia, and angiogenic factors.

RESULTS: All irradiated areas developed a chronic-phase wound by day 28. Hyperspectral imaging demonstrated a 21 percent decline in perfusion on day 56 (p < 0.001), whereas oxygenation levels were unchanged. A 1.7-fold reduction in blood vessel density was measured in irradiated skin compared with control tissue (p < 0.001), but no difference in epidermal cell hypoxia was observed. Vascular endothelial growth factor and related receptor expression were significantly lower in irradiated tissue.

CONCLUSIONS: The authors' analysis does not support the presence of hypoxia in chronic-phase irradiated skin but suggests that hypoperfusion may be a predominant characteristic. The concurrent states of hypoperfusion and normoxia may be explained by the lower metabolic demands of fibrosed tissue.

DOI of Published Version



Plast Reconstr Surg. 2013 Apr;131(4):707-16. doi: 10.1097/PRS.0b013e3182818b94. Link to article on publisher's site


Medical student Brian Freniere participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Plastic and reconstructive surgery

PubMed ID