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Understanding the dynamic alterations in the cerebral white matter (WM) microstructure after RT may be helpful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the dynamic alterations in the whole brain WM microstructure in patients with NPC in the 12\u00a0months after RT using multishell diffusion MRI (MS\u2010dMRI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Single\u2010center longitudinal study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 28 treatment\u2010na\u00efve patients with pathologically confirmed NPC (age: 39.68\u2009\u00b1\u20098.93\u2009years, 11 female) and 20 healthy controls (age: 40.65\u2009\u00b1\u20099.76\u2009years, 7 female).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequences<\/jats:title><jats:p>A 3\u2009T, <jats:styled-content style=\"fixed-case\">MS\u2010dMRI<\/jats:styled-content> using a single\u2010shot echo planar imaging sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>MS\u2010dMRI was acquired at baseline for the NPC patients and healthy controls, at 0\u20133 (acute, AC), 6 (early delayed, ED) and 12\u00a0months (late delayed, LD) after RT for the NPC patients. The mean and maximum radiation doses to the temporal lobe were acquired. The quality of images was reviewed. MS\u2010dMRI was analyzed using tract\u2010based spatial statistics (TBSS). The presentations of injury were defined by the findings of TBSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Chi\u2010square, <jats:italic>t<\/jats:italic> tests, repeated ANOVA, and Spearman\u2010rank correlation analysis were used. <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 was considered to be statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TBSS showed two WM injuries (injuries 1 and 2). Injury 1 emerged in the ED phase in the bilateral temporal poles and persisted throughout the ED and LD phases. Injury 2 developed from the AC to ED phase in the bilateral hemisphere and partially recovered in the LD phase. In the ED and LD phases, the multiple diffusion metrics were well correlated (<jats:italic>r<\/jats:italic>\u2009&gt;\u20090.5 or &lt;\u22120.5) with the RT dose, especially in the WM tracts in the temporal lobes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Disparate WM injuries were observed in NPC patients after RT. The injuries may be primarily or secondarily induced by radiation. Injury 1 may be irreversible, while injury 2 seems to partially recover.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28674","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T15:59:05Z","timestamp":1678982345000},"page":"976-986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Disparate <scp>Radiation\u2010Induced<\/scp> Microstructural Injuries in <scp>Whole\u2010Brain<\/scp> White Matter of Patients With Nasopharyngeal Carcinoma: A Longitudinal Study Using <scp>Multishell<\/scp> Diffusion <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"59","author":[{"given":"Jiahui","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Medical Imaging Sun Yat\u2010sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University  Guangzhou China"},{"name":"Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhao","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University  Guangzhou China"},{"name":"Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gui","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Sun Yat\u2010sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Sun Yat\u2010sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanqiu","family":"Feng","sequence":"additional","affiliation":[{"name":"School of Biomedical 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