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Patients underwent 1.5\u00a0T or 3.0\u00a0T MRI, including diffusion-weighted sequences (b\u2009=\u2009200, 800\u00a0s\/mm\n                      <jats:sup>2<\/jats:sup>\n                      ). Three independent radiologists measured mean tumor ADC, high-ADC, and low-ADC regions at baseline and post-radiotherapy. Reproducibility was assessed using the Intraclass Correlation Coefficient (ICC). Response prediction and clinicopathological associations were evaluated using Mann\u2013Whitney U tests, logistic regression, and Spearman rank correlations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Single-timepoint ADC measurements demonstrated high inter-observer reproducibility, particularly for mean tumor ADC (ICC\u2009=\u20090.91\u20130.95). Reproducibility for ADC changes over time was lower; agreement for mean tumor ADC (ICC\u2009=\u20090.79) outperformed subregional values (ICC\u2009=\u20090.06\u20130.63). Post-treatment mean tumor ADC was significantly elevated in responders (median 2.39\u2009\u00d7\u200910\u207b\n                      <jats:sup>3<\/jats:sup>\n                      mm\n                      <jats:sup>2<\/jats:sup>\n                      \/s) versus non-responders (1.50\u2009\u00d7\u200910\u207b\n                      <jats:sup>3<\/jats:sup>\n                      mm\n                      <jats:sup>2<\/jats:sup>\n                      \/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). High follow-up ADC values (mean and high-ADC subregions) were the strongest predictors of pathological response (OR\u2009=\u200920.3\u201333.1, all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Follow-up ADC values inversely correlated with the percentage of viable tumor cells (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Post-treatment ADC measurements were highly reproducible and best predicted pathological response in our cohort. Longitudinal changes were less robust and require further research into the effect of standardized DWI protocols and more reliable techniques for sub-regional analysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00256-026-05318-9","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T04:31:49Z","timestamp":1785385909000},"page":"2845-2855","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Apparent diffusion coefficient metrics for treatment response assessment in soft tissue sarcoma: Reproducibility and prognostic value of whole-tumor and sub-regional analysis"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5371-0454","authenticated-orcid":false,"given":"Iris","family":"van der Loo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Valentini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalina","family":"Chupetlovska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Ursprung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra J.","family":"van Houdt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"Bruining","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina G. 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