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Early Temporal Cortex Changes During Radiotherapy in Cortical Mean Diffusivity and Thickness Derived From MRI.

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Radiotherapy for nasopharyngeal carcinoma causes early temporal lobe structural changes, including increased mean diffusivity and decreased cortical thickness. These changes worsen over time and show early dose-dependent associations in specific regions.

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Area of Science:

  • Neuroimaging
  • Radiotherapy Oncology
  • Neuroscience

Background:

  • Radiotherapy (RT) for nasopharyngeal carcinoma (NPC) frequently causes temporal lobe (TL) damage.
  • Early morphological changes in the TL during RT are poorly understood.
  • Identifying these changes can help mitigate long-term cognitive impairments.

Purpose of the Study:

  • To characterize early structural changes in the TL during RT.
  • To utilize cortical thickness (CTh) and cortical mean diffusivity (cMD) for assessment.
  • To explore potential dose-dependent relationships between RT and TL structural changes.

Main Methods:

  • Prospective, longitudinal study of 40 NPC patients.
  • 3T MRI including DTI and MPRAGE sequences acquired pre-treatment, mid-treatment, and post-treatment.
  • Surface-based analysis of CTh and cMD in 18 bilateral TL regions, with radiation dose mapping.

Main Results:

  • Significant increases in cMD and decreases in CTh were observed across treatment, intensifying post-treatment.
  • Early significant changes (mid-treatment) were noted in 3/18 regions for CTh and 5/18 for cMD.
  • Early dose-dependent associations were found in the right superior temporal sulcus (cMD) and left inferior temporal gyrus (CTh) after correction.

Conclusions:

  • RT-induced structural changes in the TL begin early and progress throughout treatment.
  • Limited statistical power was noted, but early dose associations warrant further investigation.
  • Larger studies are needed to fully understand early dose-response dynamics in RT-induced TL changes.