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@ARTICLE{Welzel:168288,
      author       = {T. Welzel and A. Bendinger$^*$ and C. Glowa$^*$ and I.
                      Babushkina$^*$ and M. Jugold$^*$ and P. Peschke$^*$ and J.
                      Debus$^*$ and C. P. Karger$^*$ and M. Saager$^*$},
      title        = {{L}ongitudinal {MRI} study after carbon ion and photon
                      irradiation: shorter latency time for myelopathy is not
                      associated with differential morphological changes.},
      journal      = {Radiation oncology},
      volume       = {16},
      number       = {1},
      issn         = {1748-717X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2021-00799},
      pages        = {63},
      year         = {2021},
      note         = {#EA:E040#LA:E040#},
      abstract     = {Radiation-induced myelopathy is a severe and irreversible
                      complication that occurs after a long symptom-free latency
                      time if the spinal cord was exposed to a significant
                      irradiation dose during tumor treatment. As carbon ions are
                      increasingly investigated for tumor treatment in clinical
                      trials, their effect on normal tissue needs further
                      investigation to assure safety of patient treatments.
                      Magnetic resonance imaging (MRI)-visible morphological
                      alterations could serve as predictive markers for medicinal
                      interventions to avoid severe side effects. Thus,
                      MRI-visible morphological alterations in the rat spinal cord
                      after high dose photon and carbon ion irradiation and their
                      latency times were investigated.Rats whose spinal cords were
                      irradiated with iso-effective high photon (n = 8) or carbon
                      ion (n = 8) doses as well as sham-treated control animals (n
                      = 6) underwent frequent MRI measurements until they
                      developed radiation-induced myelopathy (paresis II). MR
                      images were analyzed for morphological alterations and
                      animals were regularly tested for neurological deficits. In
                      addition, histological analysis was performed of animals
                      suffering from paresis II compared to controls.For both beam
                      modalities, first morphological alterations occurred outside
                      the spinal cord (bone marrow conversion, contrast agent
                      accumulation in the musculature ventral and dorsal to the
                      spinal cord) followed by morphological alterations inside
                      the spinal cord (edema, syrinx, contrast agent accumulation)
                      and eventually neurological alterations (paresis I and II).
                      Latency times were significantly shorter after carbon ions
                      as compared to photon irradiation.Irradiation of the rat
                      spinal cord with photon or carbon ion doses that lead to
                      $100\%$ myelopathy induced a comparable fixed sequence of
                      MRI-visible morphological alterations and neurological
                      distortions. However, at least in the animal model used in
                      this study, the observed MRI-visible morphological
                      alterations in the spinal cord are not suited as predictive
                      markers to identify animals that will develop myelopathy as
                      the time between MRI-visible alterations and the occurrence
                      of myelopathy is too short to intervene with protective or
                      mitigative drugs.},
      keywords     = {Carbon ion irradiation (Other) / Cervical spinal cord
                      (Other) / Late radiation effects (Other) / Magnetic
                      resonance imaging (Other) / Myelopathy (Other)},
      cin          = {E040 / W240 / E050},
      ddc          = {610},
      cid          = {I:(DE-He78)E040-20160331 / I:(DE-He78)W240-20160331 /
                      I:(DE-He78)E050-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33789720},
      pmc          = {pmc:PMC8011205},
      doi          = {10.1186/s13014-021-01792-8},
      url          = {https://inrepo02.dkfz.de/record/168288},
}