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Prostate Cancer: assessing the effects of androgen-deprivation therapy using quantitative diffusion-weighted and dynamic contrast-enhanced MRI

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Abstract

Purpose

To investigate the effects of androgen-deprivation therapy (ADT) on MRI parameters and evaluate their associations with treatment response measures.

Materials and methods

The study included 30 men with histopathologically confirmed prostate cancer who underwent MRI before and after initiation of ADT. Thirty-four tumours were volumetrically assessed on DW-MRI (n = 32) and DCE-MRI (n = 18), along with regions of interest in benign prostatic tissue, to calculate apparent diffusion coefficient (ADC) and transfer constant (Ktrans) values. Changes in MRI parameters and correlations with clinical parameters (change in prostate-specific antigen [PSA], treatment duration, PSA nadir) were assessed.

Results

Prostate volume and PSA values decreased significantly with therapy (p < 0.001). ADC values increased significantly in tumours and decreased in benign prostatic tissue (p < 0.05). Relative changes in ADC and absolute post-therapeutic ADC values differed significantly between tumour and benign tissue (p < 0.001). Ktrans decreased significantly only in tumours (p < 0.001); relative Ktrans changes and post-therapeutic values were not significantly different between tumour and benign tissue. The relative change in tumour ADC correlated significantly with PSA decrease. No changes were associated with treatment duration or PSA nadir.

Conclusions

Multi-parametric MRI shows significant measurable changes in tumour and benign prostate caused by ADT and may help in monitoring treatment response.

Key Points

• Androgen-deprivation therapy caused changes of ADC, K trans in tumour and benign prostate.

• Prostate volume and PSA values decreased significantly with therapy.

• ADC values may be helpful for monitoring treatment response.

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Acknowledgements

The authors thank Ada Muellner, MS, for editing of the manuscript. The scientific guarantor of this publication is Dr. Andreas M. Hötker. 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 from the Peter Michael Foundation. Chaya Moskowitz and Junting Zheng were supported by a MSKCC Biostatistics Core grant (P30 CA008748). Chaya Moskowitz, PhD, and Junting Zheng, MS, kindly provided statistical advice for the manuscript. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. No study subjects or cohorts have been previously reported. Methodology: retrospective, experimental, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Andreas M. Hötker, Joshua E. Lantos, Hedvig Hricak & Oguz Akin

  2. Department of Diagnostic and Interventional Radiology, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Germany

    Andreas M. Hötker

  3. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Yousef Mazaheri

  4. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Junting Zheng & Chaya S. Moskowitz

  5. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Joshua Berkowitz, Xin Pei & Michael J. Zelefsky

Authors
  1. Andreas M. Hötker
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  2. Yousef Mazaheri
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  3. Junting Zheng
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  4. Chaya S. Moskowitz
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  5. Joshua Berkowitz
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  6. Joshua E. Lantos
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  7. Xin Pei
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  8. Michael J. Zelefsky
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  9. Hedvig Hricak
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  10. Oguz Akin
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Corresponding author

Correspondence to Andreas M. Hötker.

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Hötker, A.M., Mazaheri, Y., Zheng, J. et al. Prostate Cancer: assessing the effects of androgen-deprivation therapy using quantitative diffusion-weighted and dynamic contrast-enhanced MRI. Eur Radiol 25, 2665–2672 (2015). https://doi.org/10.1007/s00330-015-3688-1

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  • DOI: https://doi.org/10.1007/s00330-015-3688-1

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