Bone metastases from prostate cancer: assessing treatment response by using diffusion-weighted imaging and functional...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Prostate cancer commonly metastasizes to bone.
• Monitoring treatment response in bone metastases is crucial for patient management.
• Antiandrogen therapy is a standard treatment for advanced prostate cancer.

Purpose of the Study:

• To prospectively evaluate diffusion-weighted (DW) magnetic resonance (MR) imaging for monitoring antiandrogen therapy response in prostate cancer bone metastases.
• To assess the utility of apparent diffusion coefficient (ADC) and functional diffusion maps (DMs) in quantifying treatment effects.

Main Methods:

• Nine treatment-naive patients with prostate cancer bone metastases underwent DW MR imaging before and at 1, 2, and 3 months after antiandrogen therapy.
• Serum prostate-specific antigen (PSA) levels and mean ADCs of metastases were measured and analyzed.
• Functional DMs were used to evaluate per-voxel ADC changes.

Main Results:

• Serum PSA levels decreased by over 90% during therapy.
• Mean ADCs of bone metastases significantly increased at 1, 2, and 3 months post-treatment.
• Functional DM analysis revealed heterogeneous tumor responses, with varying proportions of voxels showing increased, unchanged, or decreased ADCs over time.

Conclusions:

• DW MR imaging is a viable tool for monitoring antiandrogen therapy response in prostate cancer bone metastases.
• Increased mean tumor ADC correlates with decreased PSA levels, indicating treatment efficacy.
• Functional DM analysis highlights the heterogeneity of tumor response to therapy at the voxel level.