The Feasibility of Total Body Photography (TBP) in Superficial Radiation Therapy (SXRT).

Introduction: This study aims to investigate the feasibility of total body photography (TBP) as a superficial radiation therapy (SXRT) treatment record, to overcome the limitations that tracings and two-dimensional (2D) photographs pose when patients return for future SXRT treatment.

Methods: A retrospective audit included 44 patients treated with SXRT at the Royal Brisbane and Women's Hospital (RBWH), from January 2020 to December 2022, with lesion characteristics and patient setup information collected. A prospective study involved applying mock lesions to four healthy volunteers, who were imaged multiple times using a three-dimensional (3D) digital photometry system. The system's feasibility as a longitudinal digital record was assessed using the 3D images.

Results: From the retrospective audit, 48 lesions were treated, 38 were located on the head and neck, and 9 on the limbs, with treatment areas ranging from 1.4-60.1 cm². This guided the creation of 16 mock lesions. The mean difference between the measured areas of face mock lesions from the captures and the actual mock lesion areas was < 0.4 cm². Neck and arm lesions showed greater mean variation (up to 3.05 cm²), particularly between sitting and standing captures. Registrations of captures found the distance between overlayed face lesions averaged < 2.7 mm. Reconstruction errors were limited to the hands, hair and ear regions.

Conclusion: TBP has sound potential as a SXRT digital treatment record. Further studies should investigate neck, limbs and scalp lesions to confirm its practical use in SXRT for a larger patient cohort.