{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T22:55:59Z","timestamp":1792364159625,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T00:00:00Z","timestamp":1684108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81972849"],"award-info":[{"award-number":["81972849"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2019YFB1311800"],"award-info":[{"award-number":["2019YFB1311800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2020AAA0109502"],"award-info":[{"award-number":["2020AAA0109502"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cognitive impairment frequently occurs in patients with brain metastases (BM) after whole\u2010brain radiotherapy (WBRT). It is crucial to explore the underlying mechanisms of cognitive impairment in BM patients receiving WBRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To detect brain microstructural alterations in patients after WBRT by neurite orientation dispersion and density imaging (NODDI), and evaluate the performance of microstructural alterations in predicting cognitive impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Twenty\u2010six patients (seven female; mean age, 60.9\u2009years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3\u2010T, multi\u2010shell diffusion\u2010weighted single\u2010shot echo\u2010planar sequence. Three\u2010dimensional magnetization\u2010prepared rapid acquisition with gradient echo sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Mini\u2010mental state examination (MMSE) evaluations were conducted prior to, following, 1 and 3\u2009months after WBRT. The diffusion data were collected twice, 1\u2009week before and 1\u2009week after WBRT. NODDI analysis was conducted to assess microstructural alterations in whole brain (orientation dispersion index, neurite density index, volume fraction of isotropic water molecules). Reliable change indices (RCI) of MMSE were used to measure cognitive decline. The performance of support vector machine models based on NODDI parameters and clinical features (prednisone usage, tumor volume, etc.) in predicting MMSE\u2010RCI was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Paired <jats:italic>t<\/jats:italic>\u2010test to assess alterations of NODDI measures and MMSE during follow\u2010up. Statistical significance level of <jats:italic>P<\/jats:italic>\u2010value &lt;0.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significantly decreased MMSE score was found at 3\u2009months after WBRT. After WBRT, corpus callosum, medial prefrontal cortex, limbic lobe, occipital lobe, parietal lobe, putamen, globus pallidus lentiform, and thalamus demonstrated damage in NODDI parameters. The predicted MMSE\u2010RCI based on NODDI features was significantly associated with the measured MMSE\u2010RCI at 1\u2009month (<jats:italic>R<\/jats:italic>\u2009=\u20090.573; <jats:italic>P<\/jats:italic>\u2009=\u20090.003) and 3\u2009months (<jats:italic>R<\/jats:italic>\u2009=\u20090.687; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) after WBRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Microstructural alterations in several brain regions including the middle prefrontal and limbic cortexes were observed in patients with BM following WBRT, which may contribute to subsequent cognitive decline.<\/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 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28781","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T09:59:43Z","timestamp":1684144783000},"page":"242-252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Relationship Between Microstructural Alterations and Cognitive Decline After <scp>Whole\u2010Brain<\/scp> Radiation Therapy for Brain Metastases: An Exploratory <scp>Whole\u2010Brain MR<\/scp> Analysis Based on Neurite Orientation Dispersion and Density Imaging"],"prefix":"10.1002","volume":"59","author":[{"given":"Weiwen","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Sir Run Run Shaw Hospital, School of Medicine Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuyun","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Sir Run Run Shaw 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