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• Clinical Article •
MRI-based longitudinal assessment of hippocampal subregion volume changes during radiotherapy in nasopharyngeal carcinoma patients
DONG Chuangwei  LIU Jin  CAO Zong  ZHOU Yanfei  YANG Lizhuang  YU Yongqiang  LI Hai 

DOI:10.12015/issn.1674-8034.2025.08.002.


[Abstract] Objective To investigate the changes in hippocampal subregion volumes in nasopharyngeal carcinoma (NPC) patients during radiotherapy and assess their correlation with radiation dose.Materials and Methods This study was a prospective longitudinal study that enrolled 41 patients with newly diagnosed NPC between March 2019 and April 2025. Brain MRI scans were performed using a 3.0 T scanner at three time points: pre-radiotherapy (1 to 2 days before treatment), mid-radiotherapy (19 to 20 days after treatment initiation), and post-radiotherapy (1 to 2 days after treatment completion). Hippocampal subregions were automatically segmented using FreeSurfer 7.3 software, and volume changes were assessed using a linear mixed model. Pearson correlation analysis was then conducted to explore the relationship between hippocampal volume changes and radiation dose.Results Compared to pre-radiotherapy, during the mid-radiotherapy period, the volumes of bilateral whole hippocampus, presubiculum, cornu ammonis 1 (CA1), CA3, CA4, granule cell-molecular layer-dentate gyrus (GC-ML-DG), molecular layer, hippocampal amygdala transition area (HATA), and right subiculum were significantly reduced (family-wise error, FWE correction, P < 0.05). After radiotherapy, except for the left HATA and right presubiculum, the volumes of other hippocampal subregions continued to decrease significantly, and the volume of the right fimbria hippocampi also decreased (FWE correction, P < 0.05). The volume change in the left hippocampal tail was significantly negatively correlated with the left hippocampal radiation dose (r = -0.555). All results were corrected for FWE using the Bonferroni method, with the significance level set at a corrected p-value of <0.05.Conclusions During radiotherapy, the volumes of several hippocampal subregions in NPC patients significantly decreased. Furthermore, after radiotherapy, the volume change in the left hippocampal tail was significantly negatively correlated with the radiation dose to the left hippocampus, indicating that the radiation dose may influence the volume change in this region.
[Keywords] head and neck neoplasms；nasopharyngeal carcinoma；radiotherapy；hippocampal subregions；dose-response relationship；magnetic resonance imaging

DONG Chuangwei1, 2   LIU Jin2, 3   CAO Zong2, 3   ZHOU Yanfei2, 3   YANG Lizhuang2, 3   YU Yongqiang1, 2   LI Hai1, 2, 3*  

1 Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

2 Hefei Cancer Hospital of CAS, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, China

3 Science Island Branch, University of Science and Technology of China, Hefei 230026, China

Corresponding author: LI H, E-mail: hli@cmpt.ac.cn

Conflicts of interest   None.

Received  2025-06-05
Accepted  2025-08-08
DOI: 10.12015/issn.1674-8034.2025.08.002
DOI:10.12015/issn.1674-8034.2025.08.002.

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