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European Radiology

, Volume 27, Issue 3, pp 995–1003 | Cite as

Spinal multiparametric MRI and DEXA changes over time in men with prostate cancer treated with androgen deprivation therapy: a potential imaging biomarker of treatment toxicity

  • Jarad MartinEmail author
  • Jameen Arm
  • Joanne Smart
  • Kerrin Palazzi
  • Anne Capp
  • Paul Ainsworth
  • Gary Cowin
Magnetic Resonance

Abstract

Objectives

To explore changes in bone mineral density (BMD) measured by DEXA and MRS fat fraction (FF), Dixon FF, and ADC in lower spinal vertebral bodies in men with prostate cancer treated with androgen deprivation therapy (ADT).

Methods

Twenty-eight men were enrolled onto a clinical trial. All received ADT. DEXA imaging was performed at baseline and 12 months. L-spine MRI was done at baseline and 6 months.

Results

The number of patients who underwent DEXA, Dixon, ADC, and MRS at baseline/follow-up were 28/27, 28/26, 28/26, and 22/20. An increase in FF was observed from T11 to S2 (average 1 %/vertebra). There was a positive correlation between baseline MRS FF and Dixon FF (r = 0.85, p < 0.0001) and a negative correlation between MRS FF and ADC (r = -0.56, p = 0.036). Over 6 months, MRS FF increased by a median of 25 % in relative values (p = 0.0003), Dixon FF increased (p < 0.0001) and ADC values decreased (p = 0.0014). Men with >5 % BMD loss after 1 year had triple the percentage increase in MRS FF at 6 months (61.1 % vs. 20.9 %, p = 0.19).

Conclusions

Changes are observed on L-spine MRI after 6 months of ADT. Further investigation is warranted of MRS change as a potential predictive biomarker for later BMD loss.

Key Points

Spinal marrow fat fraction increases after 6 months of androgen deprivation therapy.

More inferior vertebral bodies tend to have higher fat fractions.

MRS fat fraction changes were associated with later changes in DEXA BMD.

Keywords

Magnetic resonance imagining Bone density Prostate neoplasms Biomarkers Toxicity 

Abbreviations

ADT

Androgen depravation therapy

BMD

Bone mineral density

DEXA

Dual-energy X-ray absorptiometry

DWI

Diffusion weighted imaging

FF

Fat fraction

HRPC

High risk prostate cancer

PRESS

Point resolved spectroscopy

PROCITT

Prostate cancer imaging, treatment, and toxicity

SVS

Single voxel spectroscopic

Notes

Acknowledgements

The authors wish to acknowledge the assistance of Katie Baker and Hannah Woodford who assisted in MRI data extraction. Mary-Clare Hanlon assisted with manuscript submission. Peter Stanwell assisted with MRI sequence programming. Abbvie pharmaceuticals provided an unrestricted investigator initiated grant which funded the scans, trial management and statistical analysis. All analysis and manuscript preparation was performed without any input from Abbvie Pharmaceuticals.

The scientific guarantor of this publication is Associate Professor Jarad Martin. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by Abbvie Pharmaceuticals. Dr Kerrin Palazzi (one of the authors) kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study.

Some of the same subjects also had assays performed for circulating tumour cells, as well as a nomogram guided radiotherapy target volume, both of which have been reported separately. The current study completely addresses bone health and imaging, neither of which have been reported in the previous manuscripts.

Methodology: Prospective, diagnostic or prognostic study / observational / experimental, performed at one institution.

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Jarad Martin
    • 1
    • 2
    • 3
    Email author
  • Jameen Arm
    • 4
  • Joanne Smart
    • 1
  • Kerrin Palazzi
    • 5
  • Anne Capp
    • 1
    • 2
  • Paul Ainsworth
    • 6
  • Gary Cowin
    • 3
  1. 1.Department of Radiation OncologyCalvary Mater NewcastleNewcastleAustralia
  2. 2.School of Medicine and Public HealthUniversity of NewcastleNewcastleAustralia
  3. 3.Centre for Advanced ImagingUniversity of QueenslandBrisbaneAustralia
  4. 4.Hunter New England ImagingNewcastleAustralia
  5. 5.CREDITSS, Hunter Medical Research InstituteNewcastleAustralia
  6. 6.Department of UrologyHunter New England HealthNewcastleAustralia

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