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Published on: March 21, 2025
Multiparametric MRI as a Biomarker of Response to Neoadjuvant Therapy for Localized Prostate Cancer-A Pilot Study
Fiona M Fennessy1, Andriy Fedorov2, Mark G Vangel3
1Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiology, Dana-Farber Cancer Institute, DL-198, 450 Brookline Ave, Boston 02215 Massachusetts.
Multiparametric MRI (mpMRI) shows promise as a biomarker for assessing response to androgen deprivation therapy (ADT) in prostate cancer (PCa). This pilot study suggests mpMRI can predict residual cancer burden after ADT, aiding personalized treatment strategies.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Prostate cancer (PCa) treatment often involves neoadjuvant androgen deprivation therapy (ADT).
- Assessing treatment response is crucial for tailoring therapy and improving patient outcomes.
- Multiparametric MRI (mpMRI) offers a non-invasive method to evaluate tumor characteristics.
Purpose of the Study:
- To investigate the utility of multiparametric MRI (mpMRI) as a biomarker for treatment response in prostate cancer (PCa) patients undergoing neoadjuvant androgen deprivation therapy (ADT).
- To evaluate mpMRI's ability to predict residual cancer burden (RCB) after neoadjuvant ADT.
Main Methods:
- A prospective study involving eight localized PCa patients who underwent baseline mpMRI before and after 6 months of ADT, followed by prostatectomy.
- mpMRI indices, including apparent diffusion coefficient (ADC) and dynamic contrast-enhanced (DCE) metrics (Ktrans, AUC90), were analyzed in tumor and normal regions of interest (TROI/NROI).
- Residual cancer burden (RCB) was assessed using both mpMRI and prostatectomy specimens, with statistical analyses including paired t-tests and Spearman's rank correlation.
Main Results:
- Baseline mpMRI showed significant differences between TROI and NROI in ADC and DCE metrics.
- Post-treatment, a decrease in TROI Ktrans and AUC90 was observed, alongside a reduction in tumor volume, indicating treatment response.
- mpMRI-based RCB correlated well with pathology-based RCB (ρ = 0.74-0.81, p < 0.05), and pathology-based RCB correlated with post-treatment DCE metrics and ADC.
Conclusions:
- Multiparametric MRI (mpMRI) shows potential as a non-invasive biomarker to assess treatment response to neoadjuvant androgen deprivation therapy (ADT) in prostate cancer (PCa).
- mpMRI may serve as a surrogate for residual cancer burden (RCB) assessment, potentially guiding individualized treatment strategies for PCa.
- Further research with larger cohorts is warranted to validate these findings and optimize mpMRI's role in PCa management.
