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@ARTICLE{Witzmann:271240,
      author       = {K. Witzmann and F. Raschke and S. Löck$^*$ and T. Wesemann
                      and M. Krause$^*$ and J. Linn and E. Troost$^*$},
      title        = {{U}nchanged perfusion in normal-appearing white and grey
                      matter of glioma patients nine months after proton beam
                      irradiation.},
      journal      = {Acta oncologica},
      volume       = {62},
      number       = {2},
      issn         = {0284-186X},
      address      = {Abingdon},
      publisher    = {Taylor $\&$ Francis Group},
      reportid     = {DKFZ-2023-00372},
      pages        = {141-149},
      year         = {2023},
      note         = {2023 Feb;62(2):141-149},
      abstract     = {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.},
      keywords     = {Dynamic susceptibility contrast (Other) / normal-appearing
                      brain tissue (Other) / perfusion changes (Other) / proton
                      beam irradiation (Other) / radio(chemo)therapy (Other) /
                      relative cerebral blood volume (Other)},
      cin          = {DD01},
      ddc          = {610},
      cid          = {I:(DE-He78)DD01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36801809},
      doi          = {10.1080/0284186X.2023.2176254},
      url          = {https://inrepo02.dkfz.de/record/271240},
}