Disparate Radiation‐Induced Microstructural Injuries in Whole‐Brain White Matter of Patients With Nasopharyngeal Carcinoma: A Longitudinal Study Using Multishell Diffusion MRI

Background Evidence for prevention strategies of radiotherapy (RT)‐related injury in patients with nasopharyngeal carcinoma (NPC) was lacking. Understanding the dynamic alterations in the cerebral white matter (WM) microstructure after RT may be helpful. Purpose To investigate the dynamic alterations in the whole brain WM microstructure in patients with NPC in the 12 months after RT using multishell diffusion MRI (MS‐dMRI). Study Type Single‐center longitudinal study. Population A total of 28 treatment‐naïve patients with pathologically confirmed NPC (age: 39.68 ± 8.93 years, 11 female) and 20 healthy controls (age: 40.65 ± 9.76 years, 7 female). Field Strength/Sequences A 3 T, MS‐dMRI using a single‐shot echo planar imaging sequence. Assessment MS‐dMRI was acquired at baseline for the NPC patients and healthy controls, at 0–3 (acute, AC), 6 (early delayed, ED) and 12 months (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‐dMRI was analyzed using tract‐based spatial statistics (TBSS). The presentations of injury were defined by the findings of TBSS. Statistical Tests Chi‐square, t tests, repeated ANOVA, and Spearman‐rank correlation analysis were used. P 0.5 or