Localized Prostate Cancer: Effect of Hormone Deprivation Therapy Measured by Using Combined Three-dimensional¹H MR Spectroscopy and MR Imaging: Clinicopathologic Case-controlled Study

Abstract

When performed within 4 months after initiating hormone deprivation therapy, combined MR imaging/3D MR spectroscopic imaging had the same accuracy in localizing prostate cancer as in nontreated patients.

Combined magnetic resonance imaging and spectroscopic imaging approach to molecular imaging of prostate cancer

“…These initial studies suggested that MRSI could discriminate successful therapy (complete loss of prostatic metabolites) from residual disease. Subsequent studies have indicated that MRSI can also detect residual disease after unsuccessful hormone deprivation therapy (87,88) and radiation therapy (89). Figure 5 shows an example of a patient with biopsy-proven cancer in the left lobe, who had a PSA of 0.6 ng/ml at the time of the MRI/MRSI exam, which was almost 3 years after intensity modulated radiation therapy was administered.…”

“…Additionally, recovery of bilateral metabolic abnormalities consistent with biopsy findings prior to therapy was observed. Studies are currently under way to investigate the accuracy of MRI/MRSI in assessing the presence and spatial extent of prostate cancer after these therapies (87); the prognostic value of the time course to metabolic atrophy; the duration of undetectable metabolism; and the rate of metabolic recovery, particularly of cancer. The detection of residual cancer at an early stage following treatment, and the ability to monitor the time course of therapeutic response would allow earlier intervention with additional therapy and provide a more quantitative assessment of therapeutic efficacy.…”

Effect on therapeutic ratio of planning a boosted radiotherapy dose to the dominant intraprostatic tumour lesion within the prostate based on multifunctional MR parameters

“…8 mpMRI data are reliable only if acquired before androgen deprivation (hormone) therapy, as there is profound functional signal degradation after hormone therapy. [9][10][11] Our standard institutional practice for intermediate-and high-risk localized prostate cancer uses hormone therapy for 3-6 months prior to external beam radiotherapy, [12][13][14] so modelling a radiation boost to mpMRI-defined tumour nodules requires acquisition of functional data before hormone therapy to be registered with anatomical images obtained post hormone treatment and immediately prior to radiotherapy 15 in order to translate the tumour location to radiotherapy planning CT images. The aim of this planning study therefore was to demonstrate the use of a mpMRI-defined DIL to create a radiotherapy boost volume.…”

Molecular imaging for personalized cancer care

“…Studies have shown that MRSI is able to discriminate residual or recurrent prostate cancer from benign and necrotic tissue after radiotherapy (Pickett et al, 2004;Roach et al, 2001), cryosurgery (Mueller-Lisse et al, 2001a;Parivar et al, 1996;Parivar and Kurhanewicz, 1998), and hormone deprivation therapy (Mueller-Lisse et al, 2001a, 2001b. Early detection of residual cancer with MRSI may allow early intervention with additional therapy.…”