Evaluation of Therapeutic Response to Endocrine Therapy for Prostate Cancer by MRI Diffusion-weighted Imaging Based on PI-RADSv2.1

LI Basen; LIU Liangjin; RUAN Yajun; TAN Fangqin; LI Qin; HAN Yunfeng

doi:10.3971/j.issn.1000-8578.2023.22.1396

Cancer Research on Prevention and Treatment > 2023 > 50(7): 694-699. > DOI: 10.3971/j.issn.1000-8578.2023.22.1396

LI Basen, LIU Liangjin, RUAN Yajun, TAN Fangqin, LI Qin, HAN Yunfeng. Evaluation of Therapeutic Response to Endocrine Therapy for Prostate Cancer by MRI Diffusion-weighted Imaging Based on PI-RADSv2.1[J]. Cancer Research on Prevention and Treatment, 2023, 50(7): 694-699. DOI: 10.3971/j.issn.1000-8578.2023.22.1396

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Evaluation of Therapeutic Response to Endocrine Therapy for Prostate Cancer by MRI Diffusion-weighted Imaging Based on PI-RADSv2.1

1.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China
2.
Department of Radiology, Hubei No. 3 People's Hospital of Jianghan University, Wuhan 430033, China
3.
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China
4.
Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China

Funding:

Natural Science Foundation of Hubei Province 2022CFB217

Hubei Province Key Laboratory of Molecular Imaging Grant 2020fzyx011

More Information

Corresponding author:
HAN Yunfeng, E-mail: 419837477@qq.com
Received Date: November 23, 2022
Revised Date: April 17, 2023
Available Online: January 12, 2024

Graphical Abstract

Abstract

Abstract

Objective
To investigate the value of MRI diffusion-weighted imaging (DWI) technique in endocrine therapy for prostate cancer (PCa) based on PI-RADSv2.1.
Methods
A retrospective analysis of 57 patients with pathologically confirmed PCa was conducted. All patients underwent multi-parametric MRI (mpMRI) according to PI-RADS v2.1 technical specifications before biopsy and six months after endocrine therapy. The apparent diffusion coefficient (ADC) values were measured in cancer and non-cancer areas before biopsy and six months after endocrine therapy. Patients were grouped based on the mRECIST criteria and PSA level into responders (n=45) and non-responders (n=12). ROC curves were obtained to assess the correlation between changes in ADC values and PSA values before and after endocrine therapy.
Results
In the responder group, the ADC value of the cancer areas was increased significantly after endocrine therapy (P<0.001). No statistically significant difference of the ADC value of the cancer areas was found in the non-responder group before and six months after endocrine therapy (P=0.714). The ADC change of responders and non-responder groups were (0.411±0.178)×10^-3 mm²/s and (-0.014±0.125)×10^-3 mm²/s, respectively (P<0.001); the ADC ratio were (60.603±30.201)% and (-1.096±13.175)%, respectively (P<0.001). The cutoff value of the ADC change was 0.165 (AUC=0.974; sensitivity, 88.89%; specificity, 100.00%; PPV, 100.00%; NPV, 70.59%). The cutoff value of ADC ratio was 16.827% (AUC=0.980; sensitivity, 91.11%; specificity, 100.00%; PPV, 100.00%; NPV, 75.00%). The ADC values were negatively correlated with serum PSA before and after endocrine therapy.
Conclusion
The ADC change and ADC ratio may be facilitated to monitor the efficacy of endocrine therapy for PCa. The ADC values were negatively correlated with serum PSA.
- Prostate cancer,
- Diffusion-weighted imaging,
- Apparent diffusion coefficient,
- Endocrine therapy,
- Prostate-specific antigen

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Competing interests: The authors declare that they have no competing interests.

References (29)

References

[1]	Zhai Z, Zheng Y, Li N, et al. Incidence and disease burden of prostate cancer from 1990 to 2017: Results from the Global Burden of Disease Study 2017[J]. Cancer, 2020, 126(9): 1969-1978. doi: 10.1002/cncr.32733
[2]	顾伟杰, 朱耀. 2022版《CSCO前列腺癌诊疗指南》更新要点解读[J]. 中国肿瘤外科杂志, 2022, 14(3): 224-232. doi: 10.3969/j.issn.1674-4136.2022.03.004 Gu WJ, Zhu Y. Update and interpretation of the 2022 Guidelines for the Diagnosis and Treatment of Prostate Cancer by Chinese Society of Clinical Oncology(CSCO)[J]. Zhongguo Zhong Liu Wai Ke Za Zhi, 2022, 14(3): 224-232. doi: 10.3969/j.issn.1674-4136.2022.03.004
[3]	国家癌症中心, 国家肿瘤质控中心前列腺癌质控专家委员会. 中国前列腺癌规范诊疗质量控制指标(2022版)[J]. 中华肿瘤杂志, 2022, 44(10): 1011-1016. doi: 10.3760/cma.j.cn112152-20220803-00530 National Cancer Center, Prostate Cancer Expert Committee of National Cancer Quality Control Center. Quality control index for standardized diagnosis and treatment of prostate cancer in China (2022 edition)[J]. Zhonghua Zhong Liu Za Zhi, 2022, 44(10): 1011-1016. doi: 10.3760/cma.j.cn112152-20220803-00530
[4]	李星, 曾晓勇. 中国前列腺癌流行病学研究进展[J]. 肿瘤防治研究, 2021, 48(1): 98-102. doi: 10.3971/j.issn.1000-8578.2021.20.0370 Li X, Zeng XY. Advances in Epidemiology of Prostate Cancer in China[J]. Zhong Liu Fang Zhi Yan Jiu, 2021, 48(1): 98-102. doi: 10.3971/j.issn.1000-8578.2021.20.0370
[5]	Liu W, Yao Y, Liu X, et al. Neoadjuvant hormone therapy for patients with high-risk prostate cancer: a systematic review and meta-analysis[J]. Asian J Androl, 2021, 23(4): 429-436. doi: 10.4103/aja.aja_96_20
[6]	Lo GC, Margolis DJA. Prostate MRI with PI-RADS v2.1: initial detection and active surveillance[J]. Abdom Radiol(NY), 2020, 45(7): 2133-2142. doi: 10.1007/s00261-019-02346-z
[7]	Barth BK, Martini K, Skawran SM, et al. Value of an online PI-RADS v2.1 score calculator for assessment of prostate MRI[J]. Eur J Radiol Open, 2021, 8: 100332. doi: 10.1016/j.ejro.2021.100332
[8]	张贝, 王玮, 宦怡, 等. DWI评估内分泌治疗前列腺癌疗效及其与PSA的相关性[J]. 中国医学影像技术, 2012, 28(3): 554-557. doi: 10.13929/j.1003-3289.2012.03.039 Zhang B, Wang W, Huan Y, et al. DWI evaluation on the therapeutic effect of hormone therapy for prostate cancer and the correlation with PSA[J]. Zhongguo Yi Xue Ying Xiang Ji Shu, 2012, 28(3): 554-557. doi: 10.13929/j.1003-3289.2012.03.039
[9]	Cornford P, Bellmunt J, Bolla M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part Ⅱ: Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer[J]. Eur Urol, 2017, 71(4): 630-642. doi: 10.1016/j.eururo.2016.08.002
[10]	Ryan CJ, Smith MR, Fizazi K, et al. Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study[J]. Lancet Oncol, 2015, 16(2): 152-160. doi: 10.1016/S1470-2045(14)71205-7
[11]	米悦, 吴静云, 沈棋, 等. 磁共振扩散加权成像检查对前列腺癌新辅助内分泌治疗疗效的预测价值[J]. 中华泌尿外科杂志, 2020, 41(2): 120-125. doi: 10.3760/cma.j.issn.1000-6702.2020.02.008 Mi Y, Wu JY, SQ, et al. Evaluation and prediction of therapeutic response to neoadjuvant androgen deprivation therapy for prostate cancer by diffusion weighted imaging[J]. Zhonghua Mi Niao Wai Ke Za Zhi, 2020, 41(2): 120-125. doi: 10.3760/cma.j.issn.1000-6702.2020.02.008
[12]	李拔森, 王良. 第二版前列腺影像报告和数据系统(PI-RADS)解读[J]. 中华放射学杂志, 2015, 49(10): 798-800. doi: 10.3760/cma.j.issn.1005-1201.2015.10.023 Li BS, Wang L. Interpretation of prostate imaging reporting and data system version 2.0(PI-RADS v2.1)[J]. Zhonghua Fang She Xue Za Zhi, 2015, 49(10): 798-800. doi: 10.3760/cma.j.issn.1005-1201.2015.10.023
[13]	Wu X, Reinikainen P, Kapanen M, et al. Diffusion-weighted MRI Provides a Useful Biomarker for Evaluation of Radiotherapy Efficacy in Patients with Prostate Cancer[J]. Anticancer Res, 2017, 37(9): 5027-5032.
[14]	Liu W, Liu XH, Tang W, et al. Histogram analysis of stretched-exponential and monoexponential diffusion-weighted imaging models for distinguishing low and intermediate/high gleason scores in prostate carcinoma[J]. J Magn Reson Imaging, 2018, 48(2): 491-498. doi: 10.1002/jmri.25958
[15]	Hötke AM, Mazaheri Y, Zheng J, et al. Prostate Cancer: assessing the effects of androgen-deprivation therapy using quantitative diffusion-weighted and dynamic contrast-enhanced MRI[J]. Eur Radiol, 2015, 25(9): 2665-2672. doi: 10.1007/s00330-015-3688-1
[16]	Kim AY, Kim CK, Park SY, et al. Diffusion-weighted imaging to evaluate for changes from androgen deprivation therapy in prostate cancer[J]. AJR Am J Roentgenol, 2014, 203(6): W645-W650. doi: 10.2214/AJR.13.12277
[17]	Murphy WM, Soloway MS, Barrows GH. Pathologic changes associated with androgen deprivation therapy for prostate cancer[J]. Cancer, 1991, 68(4): 821-828. doi: 10.1002/1097-0142(19910815)68:4<821::AID-CNCR2820680426>3.0.CO;2-S
[18]	Fennessy FM, Fedorov A, Vangel MG, et al. Multiparametric MRI as a Biomarker of Response to Neoadjuvant Therapy for Localized Prostate Cancer-A Pilot Study[J]. Acad Radiol, 2020, 27(10): 1432-1439. doi: 10.1016/j.acra.2019.10.017
[19]	Barrett T, Gill AB, Kataoka MY, et al. DCE and DW MRI in monitoring response to androgen deprivation therapy in patients with prostate cancer: a feasibility study[J]. Magn Reson Med, 2012, 67(3): 778-785. doi: 10.1002/mrm.23062
[20]	Reuter VE. Pathological changes in benign and malignant prostatic tissue following androgen deprivation therapy[J]. Urology, 1997, 49(3A Suppl): 16-22.
[21]	Petraki CD, Sfikas CP. Histopathological changes induced by therapies in the benign prostate and prostate adenocarcinoma[J]. Histol Histopathol, 2007, 22(1): 107-118.
[22]	Padhani AR, Liu G, Koh DM, et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations[J]. Neoplasia, 2009, 11(2): 102-125. doi: 10.1593/neo.81328
[23]	黄昭君, 李拔森, 谭方琴, 等. 第2.1版前列腺影像报告和数据系统对有临床意义前列腺癌的诊断价值[J]. 现代泌尿生殖肿瘤杂志, 2021, 13(5): 278-283. doi: 10.3870/j.issn.1674-4624.2021.05.006 Huang ZJ, Li BS, Tan FQ, et al. The diagnostic value of PI-RADS v2.1 for detecting clinically significant prostate cancer[J]. Xian Dai Mi Niao Sheng Zhi Zhong Liu Za Zhi, 2021, 13(5): 278-283. doi: 10.3870/j.issn.1674-4624.2021.05.006
[24]	杨硕, 张彩元, 张跃跃, 等. 第2.1版前列腺影像报告与数据系统对移行带病变的诊断价值[J]. 中华医学杂志, 2020, 100(45): 3609-3613. doi: 10.3760/cma.j.cn112137-20200506-01442 Yang S, Zhang CY, Zhang YY, et al. The diagnostic value of version 2.1 prostate imaging reporting and data system for prostate transitional zone lesions[J]. Zhonghua Yi Xue Za Zhi, 2020, 100(45): 3609-3613. doi: 10.3760/cma.j.cn112137-20200506-01442
[25]	张丹, 朱子超, 宋娜, 等. PI-RADS v2.1和PI-RADS v2对移行带前列腺癌诊断价值的研究[J]. 磁共振成像, 2022, 13(1): 54-58. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC202201011.htm Zhang D, Zhu ZC, Song N, et al. Study of PI-RADS v2.1 and PI-RADS v2 for diagnostic value of transition zone prostate cancer[J]. Ci Gong Zhen Cheng Xiang, 2022, 13(1): 54-58. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC202201011.htm
[26]	Bhayana R, O'Shea A, Anderson MA, et al. PI-RADS versions 2 and 2.1: Interobserver Agreement and Diagnostic Performance in Peripheral and Transition Zone Lesions Among Six Radiologists [J]. AJR Am J Roentgenol, 2021, 217(1): 141-151.
[27]	Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2[J]. Eur Urol, 2019, 76(3): 340-351.
[28]	王慧慧. 前列腺多参数磁共振成像进展: PI-RADS v2.1解读[J]. 实用放射学杂志, 2020, 36(11): 1865-1868. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR202307061.htm Wang HH. Multiparametric prostate MRI progress: interpretation of PI-RADS v2.1[J]. Shi Yong Fang She Xue Za Zhi, 2020, 36(11): 1865-1868. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR202307061.htm
[29]	单春辉, 暴云锋, 赵明娟, 等. IVIM-DWI技术对前列腺癌内分泌治疗效果的应用研究[J]. 磁共振成像, 2020, 11(4): 291-295. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC202004012.htm Shan CH, Bao YF, Zhao MJ, et al. Research on IVIM-DWI technique in endocrine treatment effect of prostate cancer[J]. Ci Gong Zhen Cheng Xiang, 2020, 11(4): 291-295. https://www.cnki.com.cn/Article/CJFDTOTAL-CGZC202004012.htm

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[10]	Xia Ji Rong, . Assay and Used of Prostate Spectisc Antigen[J]. Cancer Research on Prevention and Treatment, 1997, 24(1): 40-41.

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Evaluation of Therapeutic Response to Endocrine Therapy for Prostate Cancer by MRI Diffusion-weighted Imaging Based on PI-RADSv2.1