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The gross tumor volume (GTV) was delineated on the T2 Flair. The hyper-perfusion region of the GTV (GTV-ASL) was determined by 3D-ASL, and the GTV-SUB was obtained by subtracting the GTV-ASL from the GTV. The clinical target volume (CTV) was created by iso-tropically expanding the GTV by 1\u00a0cm. The planning target volume (PTV), PTV-ASL were obtained by expanding\u00a0the external margins of the CTV, GTV-ASL, respectively. PTV-SUB was generated by subtracting PTV-ASL from PTV. Three plans were generated for each patient: a conventional plan (plan 1) without dose escalation delivering 95\u2013110% of 45\u201360\u00a0Gy in 1.8\u20132\u00a0Gy fractions to the PTV and two dose-painting plans (plan 2 and plan 3) with dose escalating by 10\u201320% (range, 50\u201372\u00a0Gy) to the PTV-ASL based on plan 1. The plan 3 was obtained from plan 2 without the maximum dose constraint. The dosimetric differences among the three plans were compared.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Results<\/jats:title>\n              <jats:p>The volume ratio of the PTV-ASL to the PTV was (23.49\u2009\u00b1\u200911.94)% (<jats:italic>Z<\/jats:italic>\u2009=\u2009\u2212\u00a03.724, <jats:italic>P<\/jats:italic>\u2009=\u20090.000). Compared with plan 1, D<jats:sub>2%<\/jats:sub>, D<jats:sub>98%<\/jats:sub> and D<jats:sub>mean<\/jats:sub> of PTV-ASL increased by 14.67%,16.17% and 14.31% in plan2 and 19.84%,15.52% and 14.27% in plan3, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05); the D<jats:sub>2%<\/jats:sub> of the PTV and PTV-SUB increased by 11.89% and 8.34% in plan 2, 15.89% and 8.49% in plan 3, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The PTV\u00a0coverages were comparable among the three plans (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). In plan 2 and plan 3, the conformity indexes decreased by 18.60% and 12.79%; while the homogeneity index increased by 1.43 and 2 times (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Compared with plan 1, the D<jats:sub>0.1\u00a0cc<\/jats:sub> of brain stem and D<jats:sub>max<\/jats:sub> of optic chiasma were slightly increased in plan 2 and plan 3, and the absolute doses met the dose constraint. The doses of the other organs at risk (OARs) were similar among the three plans (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Conclusion<\/jats:title>\n              <jats:p>The dose delivered to hyper-perfusion volume derived from 3D-ASL can increased by 10\u201320% while respecting the constraints to the OARs for NE-LGGs, which provides a basis for future individualized and precise radiotherapy, especially if the contrast agent cannot be injected or when contrast enhancement is uncertain.<\/jats:p>\n            <\/jats:sec>","DOI":"10.1007\/s11604-022-01357-z","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T14:02:32Z","timestamp":1667829752000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Three-dimensional arterial spin labeling-guided dose painting radiotherapy for non-enhancing low-grade gliomas"],"prefix":"10.1007","author":[{"given":"Zihong","family":"Zhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanzhong","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lizhen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"issue":"3","key":"1357_CR1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1007\/s11060-020-03474-z","volume":"147","author":"DG Eichberg","year":"2020","unstructured":"Eichberg DG, Di L, Morell AA, Shah AH, Semonche AM, Chin CN, et al. 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