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In this prospective cohort study, we assessed the radiological characteristics, in terms of anatomical and functional imaging, of UM after ruthenium-106 plaque brachytherapy or proton beam therapy (PBT) and compared them to conventional ultrasound.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Twenty-six UM patients were evaluated before and 3, 6 and 12\u00a0months after brachytherapy (<jats:italic>n<\/jats:italic>\u2009=\u200913) or PBT (<jats:italic>n<\/jats:italic>\u2009=\u200913). Tumour prominences were compared between ultrasound and MRI. On diffusion-weighted imaging, the apparent diffusion value (ADC), and on perfusion-weighted imaging (PWI), the time-intensity curves (TIC), relative peak intensity and outflow percentages were determined. Values were compared between treatments and with baseline.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Pre-treatment prominences were comparable between MRI and ultrasound (mean absolute difference 0.51\u00a0mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.46), but larger differences were observed post-treatment (e.g. 3\u00a0months: 0.9\u00a0mm (<jats:italic>p<\/jats:italic>\u2009=\u20090.02)). Pre-treatment PWI metrics were comparable between treatment groups. After treatment, brachytherapy patients showed favourable changes on PWI (e.g. 67% outflow reduction at 3\u00a0months, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). After PBT, significant perfusion changes were observed at a later timepoint (e.g. 38% outflow reduction at 6\u00a0months, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). No consistent ADC changes were observed after either treatment, e.g. a 0.11\u2009\u00d7\u200910<jats:sup>\u22123<\/jats:sup>mm<jats:sup>2<\/jats:sup>\/s increase 12\u00a0months after treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.15).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>MR-based follow-up is valuable for PBT-treated patients as favourable perfusion changes, including a reduction in outflow, can be detected before a reduction in size is apparent on ultrasound. For brachytherapy, a follow-up MRI is of less value as already 3\u00a0months post-treatment a significant size reduction can be measured on ultrasound.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00234-023-03166-1","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T11:02:27Z","timestamp":1685444547000},"page":"1271-1285","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["MR-based follow-up after brachytherapy and proton beam therapy in uveal melanoma"],"prefix":"10.1007","volume":"65","author":[{"given":"Michael C. 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