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@ARTICLE{Wolf:120597,
      author       = {M. B. Wolf$^*$ and C. Edler$^*$ and D. Tichy$^*$ and M.
                      Röthke$^*$ and H.-P. Schlemmer$^*$ and K. Herfarth and D.
                      Bonekamp$^*$},
      title        = {{D}iffusion-weighted {MRI} treatment monitoring of primary
                      hypofractionated proton and carbon ion prostate cancer
                      irradiation using raster scan technique.},
      journal      = {Journal of magnetic resonance imaging},
      volume       = {46},
      number       = {3},
      issn         = {1053-1807},
      address      = {New York, NY},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2017-01025},
      pages        = {850-860},
      year         = {2017},
      note         = {2017 Sep;46(3):850-860},
      abstract     = {To investigate parametric changes in the apparent diffusion
                      coefficient (ADC) at multiple timepoints during and after
                      completion of primary proton and carbon ion irradiation of
                      prostate cancer (PCa) as compared with normal-appearing
                      prostate parenchyma.In all, 92 patients with histologically
                      confirmed PCa received either proton or carbon ion
                      hypofractionated radiotherapy (RT). All were prospectively
                      evaluated with diffusion-weighted magnetic resonance imaging
                      (DWI-MRI) at five timepoints: baseline, day 10 during
                      therapy and 6 weeks, 6 months, and 18 months after
                      treatment. Linear mixed models (LMM) were used to evaluate
                      the effects of radiation, antihormonal therapy, time, and
                      type of particle irradiation on manual ADC measurements. ADC
                      differences related to prostate-specific antigen (PSA)
                      relapse according to PSA thresholds and to Vancouver rules
                      and Phoenix criteria were examined using LMM and unpaired
                      Student's t-test.A measurable and continuous increase of
                      tumor ADC measurements from baseline (1.194 × 10(-3) mm(2)
                      /s) during (1.350 × 10(-3) mm(2) /s, day 10, P = 0.006)
                      and after treatment (1.355/1.430/1.490 × 10(-3) mm(2) /s,
                      week 6 / month 6 / month 18, P = 0.001/<0.001/<0.001)
                      was found. ADC values of normal-appearing control tissue
                      remained unchanged. Androgen deprivation (P ≥ 0.320),
                      different PSA thresholds (P = 0.634), and PSA relapse
                      criteria according to Vancouver rules (P ≥ 0.776) had no
                      effect. A weak association between 18-month measurements and
                      Phoenix criteria (P = 0.046) was found.ADC parametric
                      changes were distinct in tumor tissue, highlighting the
                      ability of diffusion MRI to evaluate different aspects of
                      the microscopic pathophysiology. Although promising, their
                      use as noninvasive imaging biomarkers requires further
                      validation.1 J. Magn. Reson. Imaging 2017.},
      cin          = {E010 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:28152251},
      doi          = {10.1002/jmri.25635},
      url          = {https://inrepo02.dkfz.de/record/120597},
}