Effects of androgen deprivation on prostatic morphology and vascular permeability evaluated with mr imaging.
OBJECTIVE
To assess magnetic resonance (MR) measures of vascular permeability of prostate cancer treated with androgen deprivation and to correlate these with morphologic appearances and serum prostate-specific antigen (PSA) levels.


METHODS
MR examinations in 56 consecutive patients with prostate cancer were performed before and after luteinizing hormone-releasing hormone analog treatment. T2-weighted and contrast medium-enhanced T1-weighted MR images were obtained. Pre- and posttreatment comparisons of morphologic features, glandular volume, and enhancement-related parameters (capillary permeability, leakage space, gadolinium accumulation) were made.


RESULTS
Fifty-five tumors were seen before treatment; 42, after treatment. Signal intensity in the peripheral zone and seminal vesicles decreased on T2-weighted images in 42 (75%) and 25 (45%) patients, respectively. Median volume in tumor decreased by 65% (95% CI: 55%, 76%); in central gland, by 30% (95% CI: 25%, 35%). Reductions in tumor permeability (P <.001) and changes in washout patterns were observed (P <.001). Tumor permeability reductions coincided with a decrease in serum PSA levels in 91% of patients. A weak correlation between tumor permeability and volume change was seen (r = 0.55, P =.04). Reductions in peripheral zone (P <.001) and central gland (P =.009) permeability were noted.


CONCLUSIONS
Androgen deprivation decreases tumor volume and vascular permeability and impairs detection of prostate cancers. Use of MR estimates of permeability may be an additional way of assessing prostatic tumor response to antiandrogen treatment.
Padhani
A R
AR
CRC Clinical Magnetic Resonance Research Group and Academic Department of Radiotherapy, Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, England. padhani@fsnet.co.uk
MacVicar
A D
AD
Gapinski
C J
CJ
Dearnaley
D P
DP
Parker
G J
GJ
Suckling
J
J
Leach
M O
MO
Husband
J E
JE
D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D002199:Capillary Permeability; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D011467:Prostate / Q000098:blood supply / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D017273:Goserelin; D017373:Cyproterone Acetate; D017430:Prostate-Specific Antigen