%0 Journal Article
%A Witzmann, Katharina
%A Raschke, Felix
%A Löck, Steffen
%A Wesemann, Tim
%A Krause, Mechthild
%A Linn, Jennifer
%A Troost, Esther
%T Unchanged perfusion in normal-appearing white and grey matter of glioma patients nine months after proton beam irradiation.
%J Acta oncologica
%V 62
%N 2
%@ 0284-186X
%C Abingdon
%I Taylor & Francis Group
%M DKFZ-2023-00372
%P 141-149
%D 2023
%Z 2023 Feb;62(2):141-149
%X Purpose: Radio(chemo)therapy is used as a standard treatment for glioma patients. The surrounding normal tissue is inevitably affected by the irradiation. The aim of this longitudinal study was to investigate perfusion alterations in the normal-appearing tissue after proton irradiation and assess the dose sensitivity of the normal tissue perfusion.Methods: In 14 glioma patients, a sub-cohort of a prospective clinical trial (NCT02824731), perfusion changes in normal-appearing white matter (WM), grey matter (GM) and subcortical GM structures, i.e. caudate nucleus, hippocampus, amygdala, putamen, pallidum and thalamus, were evaluated before treatment and at three-monthly intervals after proton beam irradiation. The relative cerebral blood volume (rCBV) was assessed with dynamic susceptibility contrast MRI and analysed as the percentage ratio between follow-up and baseline image (ΔrCBV). Radiation-induced alterations were evaluated using Wilcoxon signed rank test. Dose and time correlations were investigated with univariate and multivariate linear regression models.Results: No significant ΔrCBV changes were found in any normal-appearing WM and GM region after proton beam irradiation. A positive correlation with radiation dose was observed in the multivariate regression model applied to the combined ΔrCBV values of low (1-20 Gy), intermediate (21-40 Gy) and high (41-60 Gy) dose regions of GM (p < 0.001), while no time dependency was detected in any normal-appearing area.Conclusion: The perfusion in normal-appearing brain tissue remained unaltered after proton beam therapy. In further studies, a direct comparison with changes after photon therapy is recommended to confirm the different effect of proton therapy on the normal-appearing tissue.
%K Dynamic susceptibility contrast (Other)
%K normal-appearing brain tissue (Other)
%K perfusion changes (Other)
%K proton beam irradiation (Other)
%K radio(chemo)therapy (Other)
%K relative cerebral blood volume (Other)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:36801809
%R 10.1080/0284186X.2023.2176254
%U https://inrepo02.dkfz.de/record/271240