{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:08:47Z","timestamp":1783901327770,"version":"3.55.0"},"reference-count":19,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_raon-2022-0046_s_005\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The primary objective was to quantify changes in vascular micro-environment in spinal metastases (SM) patients treated with stereotactic body radiotherapy (SBRT) with multi-parametric dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI). The secondary objective was to study plasma biomarkers related to endothelial apoptosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2022-0046_s_006\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Patients were imaged with DCE-MRI at baseline\/1-week\/12-weeks post-SBRT. Metrics including normalised time-dependent leakage (Ktrans), permeability surface product (PS), fractional plasma volume (Vp), extracellular volume (Ve) and perfusion (F) were estimated using distributed parameter model. Serum acid sphingomyelinase (ASM) and sphingosine-1-phosphate (S1P) were quantified using ELISA. Clinical outcomes including physician-scored and patient-reported toxicity were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2022-0046_s_007\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve patients (with varying primary histology) were recruited, of whom 10 underwent SBRT. Nine patients (with 10 lesions) completed all 3 imaging assessment timepoints. One patient died due to pneumonia (unrelated) before follow-up scans were performed. Median SBRT dose was 27 Gy (range: 24\u201327) over 3 fractions (range: 2\u20133). Median follow-up for alive patients was 42-months (range: 22.3\u201354.3), with local control rate of 90% and one grade 2 or higher toxicity (vertebral compression fracture). In general, we found an overall trend of reduction at 12-weeks in all parameters (Ktrans\/PS\/Vp\/Ve\/F). Ktrans and PS showed a reduction as early as 1-week. Ve\/Vp\/F exhibited a slight rise 1-week post-SBRT before reducing below the baseline value. There were no significant changes, post-SBRT, in plasma biomarkers (ASM\/S1P).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2022-0046_s_008\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tumour vascular micro-environment (measured by various metrics) showed a general trend towards downregulation post-SBRT. It is likely that vascular-mediated cell killing contributes to excellent local control rates seen with SBRT. Future studies should evaluate the effect of SBRT on primary-specific spinal metastases (e.g., renal cell carcinoma).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/raon-2022-0046","type":"journal-article","created":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T09:15:42Z","timestamp":1670836542000},"page":"525-534","source":"Crossref","is-referenced-by-count":10,"title":["Quantifying the changes in the tumour vascular micro-environment in spinal metastases treated with stereotactic body radiotherapy - a single arm prospective study"],"prefix":"10.2478","volume":"56","author":[{"given":"Balamurugan","family":"Vellayappan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Cheong","sequence":"additional","affiliation":[{"name":"Clinical Imaging Research Centre, National University of Singapore Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salil","family":"Singbal","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Tey","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Yang Soon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Nang Leong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Haematology-Oncology, National University Cancer Institute Singapore, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sein","family":"Lwin","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chau","family":"Hung Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tan Tock Seng Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravin","family":"Periasamy","sequence":"additional","affiliation":[{"name":"Centre for Life Sciences (CeLS), National University of Singapore Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Washington , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, National University Hospital , Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"key":"2026071215153086970_j_raon-2022-0046_ref_001","doi-asserted-by":"crossref","unstructured":"Coleman RE. 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