title: DCE and DW MRI in monitoring response to androgen deprivation therapy in patients with prostate cancer: a feasibility study.
abstract: 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.
authors.affiliation: Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom. es220@radiol.cam.ac.uk
authors.forename: T
authors.initials: T
authors.lastname: Barrett
authors.forename: A B
authors.initials: AB
authors.lastname: Gill
authors.forename: M Y
authors.initials: MY
authors.lastname: Kataoka
authors.forename: A N
authors.initials: AN
authors.lastname: Priest
authors.forename: I
authors.initials: I
authors.lastname: Joubert
authors.forename: M A
authors.initials: MA
authors.lastname: McLean
authors.forename: M J
authors.initials: MJ
authors.lastname: Graves
authors.forename: S
authors.initials: S
authors.lastname: Stearn
authors.forename: D J
authors.initials: DJ
authors.lastname: Lomas
authors.forename: J R
authors.initials: JR
authors.lastname: Griffiths
authors.forename: D
authors.initials: D
authors.lastname: Neal
authors.forename: V J
authors.initials: VJ
authors.lastname: Gnanapragasam
authors.forename: E
authors.initials: E
authors.lastname: Sala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059002:Androgen Receptor Antagonists / Q000627:therapeutic use*; D000813:Anilides / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005240:Feasibility Studies; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D009942:Organometallic Compounds; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D014105:Tosyl Compounds / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D059002:Androgen Receptor Antagonists; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D003287:Contrast Media; D009570:Nitriles; D009942:Organometallic Compounds; D014105:Tosyl Compounds; D017273:Goserelin; C090600:gadobutrol; C053541:bicalutamide