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Temporal lobe (TL) radiation doses were extracted from dose\u2010volume histograms. GM\u2010based spatial statistics and surface\u2010based morphometry analyses were used to quantify microstructural and macrostructural changes, respectively. TL subregions were extracted from the Desikan\u2013Killiany atlas for the region\u2010of\u2010interest (ROI) analysis.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Chi\u2010squared tests,\n t<\/jats:italic>\n \u2010tests, repeated measures analysis of variance (ANOVA), Spearman correlation (\n r<\/jats:italic>\n ), and mediation analyses (\n p<\/jats:italic>\n \u2009<\u20090.01 for voxel\u2010wise analyses and\n p<\/jats:italic>\n \u2009<\u20090.05 for others were considered significant).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n GM<\/jats:styled-content>\n microstructural changes in\n TL<\/jats:styled-content>\n regions were mainly observed to emerge at 6\u2009months and to persist or first appear at 12\u2009months post\u2010\n RT<\/jats:styled-content>\n , representing a delayed\u2010onset pattern.\n ROI<\/jats:styled-content>\n analyses showed dose\u2010dependent alterations in diffusion metrics within the entorhinal cortex (\n EC<\/jats:styled-content>\n ) and temporal pole (\n TP<\/jats:styled-content>\n ) (|\n r<\/jats:italic>\n |\u2009=\u20090.31\u20130.66). Morphometric analysis demonstrated widespread\n TL<\/jats:styled-content>\n atrophy. Mediation analysis showed delayed\u2010onset changes in\n EC<\/jats:styled-content>\n and\n TP<\/jats:styled-content>\n that mediated macrostructural abnormalities in multiple\n TL<\/jats:styled-content>\n regions, including left middle and superior temporal gyri and right inferior temporal and parahippocampal gyri.\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusions<\/jats:title>\n This study showed delayed\u2010onset, dose\u2010sensitive microstructural changes in EC and TP that contribute to broader TL atrophy in NPC patients.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n 2.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 4.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70119","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T14:54:37Z","timestamp":1757516077000},"page":"538-548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MRI<\/scp>\n Assessment of Radiation\u2010Induced Delayed\u2010Onset Microstructural Gray Matter Changes in Nasopharyngeal Carcinoma Patients"],"prefix":"10.1002","volume":"63","author":[{"given":"Ziru","family":"Qiu","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering, Guangdong Provincial Key Laboratory of Medical Image Processing and 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, Guangdong Provincial Clinical Research Center for Cancer Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine The First Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoran","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Guangdong Provincial Key Laboratory of Medical Image Processing and Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahui","family":"Liang","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, Guangdong Provincial Clinical Research Center for Cancer 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, Guangdong Provincial Clinical Research Center for Cancer Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"YunPeng","family":"Li","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, Guangdong Provincial Clinical Research Center for Cancer Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanqiu","family":"Feng","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Guangdong Provincial Key Laboratory of Medical Image Processing and Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology Southern Medical University Guangzhou China"},{"name":"Guangdong\u2010Hong Kong\u2010Macao Greater Bay Area Center for Brain Science and Brain\u2010Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education Southern Medical University Guangzhou China"},{"name":"Department of Rehabilitation Zhujiang Hospital, Southern Medical University Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1712-630X","authenticated-orcid":false,"given":"Xiaofei","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Sun Yat\u2010Sen University Cancer Center, 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