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@ARTICLE{Bendinger:176996,
      author       = {A. Bendinger$^*$ and T. Welzel$^*$ and L. Huang$^*$ and I.
                      Babushkina$^*$ and P. Peschke$^*$ and J. Debus$^*$ and C.
                      Glowa$^*$ and C. P. Karger$^*$ and M. Saager$^*$},
      title        = {{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.},
      journal      = {Radiotherapy and oncology},
      volume       = {165},
      issn         = {0167-8140},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2021-02229},
      pages        = {126-134},
      year         = {2021},
      note         = {#EA:E040#LA:E040# / Volume 165, December 2021, Pages
                      126-134},
      abstract     = {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.},
      keywords     = {(12)C-ion irradiation (Other) / cervical spinal cord
                      (Other) / dynamic contrast-enhanced magnetic resonance
                      imaging (Other) / late radiation effects (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:34634380},
      doi          = {10.1016/j.radonc.2021.09.035},
      url          = {https://inrepo02.dkfz.de/record/176996},
}