Dose distribution of a Volumetric Modulated Arc Therapy (VMAT) plan in the axial plane

Dose distribution of a Volumetric Modulated Arc Therapy (VMAT) plan in the axial plane

3D reconstrunction of target volumes and OARs.

Dose distribution of a Volumetric Modulated Arc Therapy (VMAT) plan in the axial plane

Dose distribution of a VMAT plan in the sagittal plane

Dose distribution of a VMAT plan in the coronal plane

Dose-volume histogram (DVH) of a VMAT plan

Section of parotid lymph nodes infiltrated by nasopharyngeal nonkeratnyzing carcinoma undifferentiated subtype (UNPC). H&Ex400

Same case with necrotizing granulomatous reaction. H&Ex250

Axial T2W MR reveal isointensity mass (red arrow) confined to PMS, (NPC stage 1) in lateral pharingeal recesses (yellow arrow); retropharyngeal left node (blue arrow)

Axial T1 C+ (VIBE) MR retropharyngeal left node (blue arrow)

Sagittal T1C+ MR reveal isointensity mass (red arrow)

Sagittal T1 C+ MR, VIBE, shows a retropharingeal node (red arrow)

Fused T1 C+ (VIBE) plus DW image emphasize the NPC (red arrow) and the retropharingeal node (yellow arrow)

Axial T2W MR reveals NPC (isoiperintensity mass) confined to PMS (red arrow)

Axial T1 C+ MR, reveals NPC (enhanced mass) confined to PMS (red arrow)

Axial T2W MR shows a isointensity mass in lateral right pharyngeal recess(red arrow), invading nasal cavity

Axial T1W C+ MR shows an ehnanced mass in lateral right pharyngeal recess (red arrow)

Coronal T2W MR shows isointensity mass confined in PMS, in lateral right recess

SagittalT1 C+ MR shows enhanced mass in PMS, invading nasal cavity and partially orophangeal space (soft palate)

Coronal T1 C+ MR shows enhanced mass confined in PMS, in lateral right recess

Axial T1 C+ MR reveals NPC invading parapharingeal right space (T2 stage)

Axial DW MR, B1000 value; NPC Shows high signal intensity

ADC map. NPC shows restricted diffusion because high intrisic cellularity

Axial T2W MR

Axial T1W MR

Axial T1 C+ MR

Coronal T1 C+ MR

Sagittal T1 C+ MR

Axial T2W,MR

Axial T1W, MR

Coronal T1W C+
Tumor extends intracranially and involves cranial nerves (vidian nerve in vidian canal,yellow arrow, and mandibular nerve in foramen ovale, red arrow)

Coronal T1W C+
Tumor extends intracranially and involves cranial nerves (vidian nerve in vidian canal,yellow arrow, and mandibular nerve in foramen ovale, red arrow)

Tumor involves trigeminal ganglion ( red arrow )and CNV2 or maxillary nerve (yellow arrow)

Tumor involves trigeminal ganglion within Meckel cave (red arrow)

Coronal T2W; metastatic node in right level IB (red arrow)

Sagittal T1 C+; metastatic node in retropharingeal space (red arrow)

Coronal T1 C+, bilateral metastatic nodes in retropharingeal space (red arrow)and in left laterocervical side (yellow arrow)

Coronal T1 C+, bilateral metastatic nodes (red arrow)

Coronal T2W: metastatic nodes in left laterocervical side> 6cm

ADC MAP

Axial DW MR, B1000 value

Axial DW MR, B1000 value

ADC map

Fused T1 C+ (VIBE) plus DW image