Fig 4. Example of radiation dermatitis following focussed ultrasound-stimulated microbubbles radiation enhancement treatment.

A patient with cutaneous skin nodules (identified as patient #9 in Tables 1 and 2) received radiation therapy comprising 20 Gy in 5 fractions with electrons to the area delineated by a dotted line. The nodule, identified at baseline image and demarcated by a solid black line at the one-month follow-up, was the target for radioenhancement treatment with MRgFUS-MB. The most severe observed toxicity was grade 1 dermatitis, and the region treated with combined treatment (MRgFUS-MB + radiation) displayed a similar intensity of cutaneous toxicity compared to the areas treated with radiotherapy alone, suggesting that radiation dermatitis would likely have occurred to a comparable extent in the absence of radioenhancement therapy.