TY  - JOUR
AU  - Bendinger, Alina
AU  - Welzel, Thomas
AU  - Huang, Lifi
AU  - Babushkina, Inna
AU  - Peschke, Peter
AU  - Debus, Jürgen
AU  - Glowa, Christin
AU  - Karger, Christian P
AU  - Saager, Maria
TI  - DCE-MRI detected vascular permeability changes in the rat spinal cord do not explain shorter latency times for paresis after carbon ions relative to photons.
JO  - Radiotherapy and oncology
VL  - 165
SN  - 0167-8140
CY  - Amsterdam [u.a.]
PB  - Elsevier Science
M1  - DKFZ-2021-02229
SP  - 126-134
PY  - 2021
N1  - #EA:E040#LA:E040# / Volume 165, December 2021, Pages 126-134
AB  - Radiation-induced myelopathy, an irreversible complication occurring after a long symptom-free latency time, is preceded by a fixed sequence of magnetic resonance- (MR-) visible morphological alterations. Vascular degradation is assumed the main reason for radiation-induced myelopathy. We used dynamic contrast-enhanced (DCE-) MRI to identify different vascular changes after photon and carbon ion irradiation, which precede or coincide with morphological changes.The cervical spinal cord of rats was irradiated with iso-effective photon or carbon (12C-)ion doses. Afterwards, animals underwent frequent DCE-MR imaging until they developed symptomatic radiation-induced myelopathy (paresis II). Measurements were performed at certain time points: 1 month, 2 months, 3 months, 4 months, and 6 months after irradiation, and when animals showed morphological (such as edema/ syrinx/ contrast agent (CA) accumulation) or neurological alterations (such as, paresis I, and paresis II). DCE-MRI data was analyzed using the extended Toft's model.Fit quality improved with gradual disintegration of the blood spinal cord barrier (BSCB) towards paresis II. Vascular permeability increased three months after photon irradiation, and rapidly escalated after animals showed MR-visible morphological changes until paresis II. After 12C-ion irradiation, vascular permeability increased when animals showed morphological alterations and increased further until animals had paresis II. The volume transfer constant and the plasma volume showed no significant changes.Only after photon irradiation, DCE-MRI provides a temporal advantage in detecting early physiological signs in radiation-induced myelopathy compared to morphological MRI. As a generally lower level of vascular permeability after 12C-ions led to an earlier development of paresis as compared to photons, we conclude that other mechanisms dominate the development of paresis II.
KW  - (12)C-ion irradiation (Other)
KW  - cervical spinal cord (Other)
KW  - dynamic contrast-enhanced magnetic resonance imaging (Other)
KW  - late radiation effects (Other)
KW  - myelopathy (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:34634380
DO  - DOI:10.1016/j.radonc.2021.09.035
UR  - https://inrepo02.dkfz.de/record/176996
ER  -