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DCE and DW MRI in monitoring response to androgen deprivation therapy in patients with prostate cancer: A feasibility study
Author(s) -
Barrett T.,
Gill A. B.,
Kataoka M. Y.,
Priest A. N.,
Joubert I.,
McLean M. A.,
Graves M. J.,
Stearn S.,
Lomas D. J.,
Griffiths J. R.,
Neal D.,
Gnanapragasam V. J.,
Sala E.
Publication year - 2012
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.23062
Subject(s) - prostate cancer , medicine , androgen deprivation therapy , effective diffusion coefficient , diffusion mri , magnetic resonance imaging , prostate , radiation therapy , urology , dynamic contrast , prostate specific antigen , nuclear medicine , dynamic contrast enhanced mri , cancer , radiology
Androgen deprivation therapy (ADT) is a key primary treatment for advanced and metastatic prostate cancer and is an important neoadjuvant before radiotherapy. We evaluated 3.0 T dynamic contrast‐enhanced MRI and diffusion‐weighted (DW) MRI in monitoring ADT response. Twenty‐three consecutive patients with prostate cancer treated by primary ADT were included. Imaging was performed at baseline and 3 months posttreatment with ADT. After 3 months therapy there was a significant reduction in all dynamic contrast‐enhanced MRI parameters measured in tumor regions of interest ( K trans , k ep , v p , IAUGC‐90); P < 0.001. Areas of normal‐appearing peripheral zone showed no significant change; P = 0.285–0.879. Post‐ADT, there was no significant change in apparent diffusion coefficient values in tumors, whilst apparent diffusion coefficient values significantly decreased in areas of normal‐appearing peripheral zone, from 1.786 × 10 −3 mm 2 /s to 1.561 × 10 −3 mm 2 /s; P = 0.007. As expected the median Prostate‐Specific Antigen (PSA) significantly reduced from 30 ng/mL to 1.5 ng/mL posttreatment, and median prostate volume dropped from 47.6 cm 3 to 24.9 cm 3 ; P < 0.001. These results suggest that dynamic contrast‐enhanced MRI and diffusion‐weighted MRI offer different information but that both could prove useful adjuncts to the anatomical information provided by T2‐weighted imaging. dynamic contrast‐enhanced as a marker of angiogenesis may help demonstrate ADT resistance and diffusion‐weighted imaging may be more accurate in determining presence of tumor cell death versus residual tumor. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.