TY  - JOUR
AU  - Witzmann, Katharina
AU  - Raschke, Felix
AU  - Löck, Steffen
AU  - Wesemann, Tim
AU  - Krause, Mechthild
AU  - Linn, Jennifer
AU  - Troost, Esther
TI  - Unchanged perfusion in normal-appearing white and grey matter of glioma patients nine months after proton beam irradiation.
JO  - Acta oncologica
VL  - 62
IS  - 2
SN  - 0284-186X
CY  - Abingdon
PB  - Taylor & Francis Group
M1  - DKFZ-2023-00372
SP  - 141-149
PY  - 2023
N1  - 2023 Feb;62(2):141-149
AB  - 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.
KW  - Dynamic susceptibility contrast (Other)
KW  - normal-appearing brain tissue (Other)
KW  - perfusion changes (Other)
KW  - proton beam irradiation (Other)
KW  - radio(chemo)therapy (Other)
KW  - relative cerebral blood volume (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:36801809
DO  - DOI:10.1080/0284186X.2023.2176254
UR  - https://inrepo02.dkfz.de/record/271240
ER  -