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    Changes in prostate apparent diffusion coefficient values during radiotherapy after neoadjuvant hormones

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    Authors
    McPartlin, Andrew J
    Kershaw, L
    McWilliam, Alan
    Taylor, Benjamin
    Hodgson, Clare
    van Herk, Marcel
    Choudhury, Ananya
    Affiliation
    The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
    Issue Date
    2018
    
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    Abstract
    BACKGROUND: Changes in prostate cancer apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (MRI) provide a noninvasive method for assessing radiotherapy response. This may be attenuated by neoadjuvant hormone therapy (NA-HT). We investigate ADC values measured before, during and after external beam radiotherapy (EBRT) following NA-HT. METHODS: Patients with ?T2c biopsy-proven prostate cancer receiving 3 months of NA-HT plus definitive radiotherapy were prospectively identified. All underwent ADC-MRI scans in the week before EBRT, in the third week of EBRT and 8 weeks after its completion. Imaging was performed at 1.5?T. The tumour, peripheral zone (PZ) and central zone (CZ) of the prostate gland were identified and median ADC calculated for each region and time point. RESULTS: Between September and December 2014, 15 patients were enrolled (median age 68.3, range 57-78) with a median Gleason score of 7 (6-9) and prostate-specific antigen (PSA) at diagnosis 14 (3-197) ng/ml. Median period of NA-HT prior to first imaging was 96 days (69-115). All patients completed treatment. Median follow up was 25 months (7-34), with one patient relapsing in this time. Thirteen patients completed all imaging as intended, one withdrew after one scan and another missed the final imaging. PZ and CZ could not be identified in one patient. Median tumour ADC before, during and post radiotherapy was 1.24?×?10-3?mm2/s (interquartile range 0.16?×?10-3?mm2/s), 1.31?×?10-3?mm2/s (0.22?×?10-3?mm2/s), then 1.32?×?10-3?mm2/s (0.13?×?10-3?mm2/s) respectively (p?>?0.05). There was no significant difference between median tumour and PZ or CZ ADC at any point. Gleason score did not correlate with ADC values. CONCLUSIONS: Differences in ADC parameters of normal and malignant tissue during EBRT appear attenuated by prior NA-HT. The use of changes in ADC as a predictive tool in this group may have limited utility.
    Citation
    McPartlin A, Kershaw L, McWilliam A, Taylor MB, Hodgson C, van Herk M, et al. Changes in prostate apparent diffusion coefficient values during radiotherapy after neoadjuvant hormones. Ther Adv Urol. 2018 Dec;10(12):359-64.
    Journal
    Therapeutic Advances in Urology
    URI
    http://hdl.handle.net/10541/621527
    DOI
    10.1177/1756287218798748
    PubMed ID
    30574195
    Additional Links
    https://dx.doi.org/10.1177/1756287218798748
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1177/1756287218798748
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