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Routine MRI techniques are rather limited in assessing treatment response versus disease progression following radiation therapy as lesion size often fluctuates after both successful and unsuccessful treatment. In this study, dynamic contrast-enhanced MRI perfusion parameters were used to predict treatment success or failure regarding spinal osseous metastases and to show the concordance with lesion-size measurements in the determination of treatment success or failure. The authors found there were significant differences in the change in plasma volume following radiation treatment between their clinical response and persistent disease groups. Additionally, they demonstrated that plasma volume had a higher specificity than size measurements.