title: Volume of Bone Metastasis Assessed with Whole-Body Diffusion-weighted Imaging Is Associated with Overall Survival in Metastatic Castration-resistant Prostate Cancer.
abstract: Purpose To determine the correlation between the volume of bone metastasis as assessed with diffusion-weighted (DW) imaging and established prognostic factors in metastatic castration-resistant prostate cancer (mCRPC) and the association with overall survival (OS). Materials and Methods This retrospective study was approved by the institutional review board; informed consent was obtained from all patients. The authors analyzed whole-body DW images obtained between June 2010 and February 2013 in 53 patients with mCRPC at the time of starting a new line of anticancer therapy. Bone metastases were identified and delineated on whole-body DW images in 43 eligible patients. Total tumor diffusion volume (tDV) was correlated with the bone scan index (BSI) and other prognostic factors by using the Pearson correlation coefficient (r). Survival analysis was performed with Kaplan-Meier analysis and Cox regression. Results The median tDV was 503.1 mL (range, 5.6-2242 mL), and the median OS was 12.9 months (95% confidence interval [CI]: 8.7, 16.1 months). There was a significant correlation between tDV and established prognostic factors, including hemoglobin level (r = -0.521, P < .001), prostate-specific antigen level (r = 0.556, P < .001), lactate dehydrogenase level (r = 0.534, P < .001), alkaline phosphatase level (r = 0.572, P < .001), circulating tumor cell count (r = 0.613, P = .004), and BSI (r = 0.565, P = .001). A higher tDV also showed a significant association with poorer OS (hazard ratio, 1.74; 95% CI: 1.02, 2.96; P = .035). Conclusion Metastatic bone disease from mCRPC can be evaluated and quantified with whole-body DW imaging. Whole-body DW imaging-generated tDV showed correlation with established prognostic biomarkers and is associated with OS in mCRPC. (©) RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Raquel
authors.initials: R
authors.lastname: Perez-Lopez
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: David
authors.initials: D
authors.lastname: Lorente
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Blackledge
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: David J
authors.initials: DJ
authors.lastname: Collins
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Mateo
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Diletta
authors.initials: D
authors.lastname: Bianchini
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Aurelius
authors.initials: A
authors.lastname: Omlin
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Andrea
authors.initials: A
authors.lastname: Zivi
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Martin O
authors.initials: MO
authors.lastname: Leach
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Johann S
authors.initials: JS
authors.lastname: de Bono
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Dow-Mu
authors.initials: DM
authors.lastname: Koh
authors.affiliation: From the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Cancer Therapeutics Division, 15 Cotswold Rd, Sutton SM2 5NG, England.
authors.forename: Nina
authors.initials: N
authors.lastname: Tunariu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D064129:Prostatic Neoplasms, Castration-Resistant / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D047368:Tumor Burden; D051598:Whole Body Imaging / Q000379:methods*