{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:18:23Z","timestamp":1787807903204,"version":"build-2784847793"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assesses the value of quantitative magnetic resonance imaging (qMRI) in evaluating clival invasion (CI) and monitoring therapeutic response in locally advanced nasopharyngeal carcinoma (LA-NPC). It also investigates the relationship between qMRI parameter changes in CI and regression of nasopharyngeal soft-tissue invasion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, fifty-five LA-NPC patients with CI from a single-center underwent qMRI at baseline (t0), pre-radiotherapy (t1), mid-radiotherapy (t2), and post-radiotherapy (t3). T1, T2, and T2* mappings were measured in manually delineated volumes of interest. Patients were categorized into complete response (CR) and non-CR groups based on nasopharyngeal soft tissue tumor regression per RECIST 1.1. The cervical vertebrae served as self-controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, T1, T2, and T2* mapping values were significantly higher in clival invasion than in normal cervical vertebrae (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). During treatment, the CR group (87.3%) exhibited marked decreases in T1 values (from 841.30 [IQR:521.31] ms at baseline to 587.61 [IQR: 187.54] ms at post-RT; p&amp;lt;0.001) and T2* values (from 7.27 [IQR: 5.28] ms to 4.86 [IQR: 3.48] ms; p&amp;lt;0.001), accompanied by a significant increase in T2 values (from 89.83 [IQR: 18.25] ms to 99.79 [IQR: 12.10] ms; p&amp;lt;0.001), whereas the non-CR group showed no significant alterations in T1 and T2 mapping values (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt; 0.05). Notably, there were no significant differences in T1, T2, and T2* mapping values between t2 and t3 in the CR group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt; 0.05). Furthermore, differences between CI and cervical vertebrae measurements (\u0394T1, \u0394T2, \u0394T2*) diminished in the CR group during treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). Conversely, the non-CR group showed no significant changes in \u0394T1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.738) mapping values but did exhibit changes in \u0394T2 and \u0394T2* mapping values (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The qMRI-derived T1, T2, and T2* mapping demonstrates potential utility in monitoring CI response in LA-NPC, serving as an inherently quantitative tool that warrants further investigation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1751817","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:27:46Z","timestamp":1787804866000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative MRI in the assessment of clival invasion in locally advanced nasopharyngeal carcinoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuqing","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]},{"name":"Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors (Guangxi Medical University), Ministry of Education","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fayi","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]},{"name":"Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors (Guangxi Medical University), Ministry of Education","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunmei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]},{"name":"Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors (Guangxi Medical University), Ministry of Education","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]},{"name":"Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors (Guangxi Medical University), Ministry of Education","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]},{"name":"Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors (Guangxi Medical University), Ministry of Education","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rensheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]},{"name":"Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors (Guangxi Medical University), Ministry of Education","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, Guangxi, China"]},{"name":"Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumors (Guangxi Medical University), Ministry of Education","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/s0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma","volume":"394","author":"Chen","year":"2019","journal-title":"Lancet (London England)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.07.062","article-title":"Re-evaluation of 6th edition of Ajcc staging system for nasopharyngeal carcinoma and proposed improvement based on magnetic resonance imaging","volume":"73","author":"Mao","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2012.10.016","article-title":"Nasopharyngeal cancer: Impact of skull base invasion on patients prognosis and its potential implications on Tnm staging","volume":"82","author":"Li","year":"2013","journal-title":"Eur J Radiol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.812358","article-title":"Predicting bone metastasis risk based on skull base invasion in locally advanced nasopharyngeal carcinoma","volume":"12","author":"Wu","year":"2022","journal-title":"Front Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4103\/0971-3026.111485","article-title":"Imaging of skull base: Pictorial essay","volume":"22","author":"Raut","year":"2012","journal-title":"Indian J Radiol Imaging"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-014-0656-7","article-title":"Mri-detected skull-base invasion: Prognostic value and therapeutic implication in intensity-modulated radiotherapy treatment for nasopharyngeal carcinoma","volume":"190","author":"Cheng","year":"2014","journal-title":"Strahlentherapie und Onkologie Organ der Deutschen Rontgengesellschaft [et al]"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/ar.22507","article-title":"The incidence of invasion and metastasis of nasopharyngeal carcinoma at different anatomic sites in the skull base","volume":"295","author":"Han","year":"2012","journal-title":"Anatomical Rec (Hoboken NJ 2007)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/s0360-3016(00)00459-4","article-title":"Skull-base invasion of nasopharyngeal carcinoma: Magnetic resonance imaging findings and therapeutic implications","volume":"47","author":"Nishioka","year":"2000","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.12.007","article-title":"Nasopharyngeal carcinoma: Esmo-euracan clinical practice guidelines for diagnosis, treatment and follow-up(\u2020)","volume":"32","author":"Bossi","year":"2021","journal-title":"Ann Oncol Off J Eur Soc For Med Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1148\/rg.210150","article-title":"Adverse radiation therapy effects in the treatment of head and neck tumors","volume":"42","author":"Rocha","year":"2022","journal-title":"Radiographics A Rev Publ Radiological Soc North America Inc"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1017758","article-title":"The role of Pet\/Ct in radiotherapy for nasopharyngeal carcinoma","volume":"12","author":"Li","year":"2022","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2013.10.004","article-title":"Comparison of whole-body Mri and skeletal scintigraphy for detection of bone metastatic tumors: A meta-analysis","volume":"22","author":"Wu","year":"2013","journal-title":"Surg Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3233\/bme-130911","article-title":"Comparison of Spect\/Ct, Mri and Ct in diagnosis of skull base bone invasion in nasopharyngeal carcinoma","volume":"24","author":"Zhang","year":"2014","journal-title":"Bio-Med Mater Eng"},{"key":"B14","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1097\/RMR.0b013e31821e56f8","article-title":"Quantitative brain mri","volume":"21","author":"Pierpaoli","year":"2010","journal-title":"Topics Magnetic Resonance Imaging TMRI"},{"key":"B15","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.mric.2014.08.007","article-title":"T1 mapping: Technique and applications","volume":"23","author":"Fernandes","year":"2015","journal-title":"Magnetic Resonance Imaging Clinics North America"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.4454","article-title":"Heterogeneity analysis of Mri T2 maps for measurement of early tumor response to radiotherapy","volume":"34","author":"Tomaszewski","year":"2021","journal-title":"NMR BioMed"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1148\/rg.295095034","article-title":"Principles, techniques, and applications of T2*-based Mr imaging and its special applications","volume":"29","author":"Chavhan","year":"2009","journal-title":"Radiographics A Rev Publ Radiological Soc North America Inc"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.mric.2019.04.008","article-title":"T2* mapping techniques: Iron overload assessment and other potential clinical applications","volume":"27","author":"Menacho","year":"2019","journal-title":"Magnetic Resonance Imaging Clinics North America"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1097\/rli.0000000000000579","article-title":"Quantitative assessment of bone metastasis in prostate cancer using synthetic magnetic resonance imaging","volume":"54","author":"Arita","year":"2019","journal-title":"Invest Radiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s40644-020-00365-4","article-title":"The diagnostic performance of quantitative mapping in breast cancer patients: A preliminary study using synthetic Mri","volume":"20","author":"Meng","year":"2020","journal-title":"Cancer Imaging Off Publ Int Cancer Imaging Soc"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-022-09191-7","article-title":"Quantitative synthetic Mri for predicting locally advanced rectal cancer response to neoadjuvant chemoradiotherapy","volume":"33","author":"Lian","year":"2023","journal-title":"Eur Radio"},{"key":"B22","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s13244-023-01411-y","article-title":"Pretreatment synthetic magnetic resonance imaging predicts disease progression in nonmetastatic nasopharyngeal carcinoma after intensity modulation radiation therapy","volume":"14","author":"Yang","year":"2023","journal-title":"Insights into Imaging"},{"key":"B23","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s12880-023-00968-w","article-title":"The utility of texture analysis based on quantitative synthetic magnetic resonance imaging in nasopharyngeal carcinoma: A preliminary study","volume":"23","author":"Yang","year":"2023","journal-title":"BMC Med Imaging"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: Revised Recist guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/s0009-9260(96)80056-0","article-title":"Skull base erosion in nasopharyngeal carcinoma: Detection by Ct and Mri","volume":"51","author":"Chong","year":"1996","journal-title":"Clin Radiol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-021-01342-y","article-title":"The evolution of bone marrow signal changes at the skull base in nasopharyngeal carcinoma patients treated with radiation therapy","volume":"126","author":"Parlak","year":"2021","journal-title":"La Radiologia Med"},{"key":"B27","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/idj.12318","article-title":"Osteoradionecrosis of the jaws: Definition, epidemiology, staging and clinical and radiological findings. A concise review","volume":"68","author":"Chronopoulos","year":"2018","journal-title":"Int Dental J"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-023-04338-z","article-title":"Radiation osteitis: Incidence and clinical impact in the setting of radiation treatment for soft tissue sarcoma","volume":"52","author":"Vijayakumar","year":"2023","journal-title":"Skeletal Radiol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16091714","article-title":"Deep learning reconstruction for Dwis by Epi and Fase sequences for head and neck tumors","volume":"16","author":"Ikeda","year":"2024","journal-title":"Cancers"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.27770","article-title":"Investigation of synthetic magnetic resonance imaging applied in the evaluation of the tumor grade of bladder cancer","volume":"54","author":"Cai","year":"2021","journal-title":"J Magnetic Resonance Imaging JMRI"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2021.109658","article-title":"Prediction of pathological prognostic factors of rectal cancer by relaxation maps from synthetic magnetic resonance imaging","volume":"138","author":"Zhao","year":"2021","journal-title":"Eur J Radiol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-022-09027-4","article-title":"Synthetic Mri in differentiating benign from metastatic retropharyngeal lymph node: Combination with diffusion-weighted imaging","volume":"33","author":"Wang","year":"2023","journal-title":"Eur Radio"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10100421","article-title":"Primary human breast adenocarcinoma: Imaging and histologic correlates of intrinsic susceptibility-weighted Mr imaging before and during chemotherapy","volume":"257","author":"Li","year":"2010","journal-title":"Radiology"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2017.18.1.238","article-title":"Estimation of T2* relaxation time of breast cancer: Correlation with clinical, imaging and pathological features","volume":"18","author":"Seo","year":"2017","journal-title":"Korean J Radiol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1002\/nbm.3420","article-title":"Modeling of T2* decay in vertebral bone marrow fat quantification","volume":"28","author":"Karampinos","year":"2015","journal-title":"NMR BioMed"},{"key":"B36","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.ejrad.2018.09.021","article-title":"Quantitative evaluation of T2* relaxation times for the differentiation of acute benign and Malignant vertebral body fractures","volume":"108","author":"Schmeel","year":"2018","journal-title":"Eur J Radiol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.21037\/qims-20-1373","article-title":"Vertebral bone marrow T2* mapping using chemical shift encoding-based water-fat separation in the quantitative analysis of lumbar osteoporosis and osteoporotic fractures","volume":"11","author":"Leonhardt","year":"2021","journal-title":"Quantitative Imaging Med Surg"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2002.07.011","article-title":"Excellent disease control and survival in patients with advanced nasopharyngeal cancer treated with chemoradiation","volume":"20","author":"Rischin","year":"2002","journal-title":"J Clin Oncol Off J Am Soc Clin Oncol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.7150\/jca.33303","article-title":"Safety and effectiveness of de-escalated radiation dose in T1-3 nasopharyngeal carcinoma: A propensity matched analysis","volume":"10","author":"Wang","year":"2019","journal-title":"J Cancer"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2023.113336","article-title":"Reduced-dose radiotherapy for Epstein-Barr virus DNA selected staged Iii nasopharyngeal carcinoma: A single-arm, phase 2 trial","volume":"194","author":"Guo","year":"2023","journal-title":"Eur J Cancer (Oxford Engl 1990)"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1751817\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:27:48Z","timestamp":1787804868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1751817\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":40,"alternative-id":["10.3389\/fonc.2026.1751817"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1751817","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"article-number":"1751817"}}