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Prognostic value of whole-body diffusion-weighted imaging with background body signal suppression in CRPC patients
Yumiko Kono1, Keita Utsunomiya2, Satoaki Nakamura2
1Department of Radiology, Kansai Medical University, 2-5-1 Shin-machi, Hirakata City, Osaka, 573-1010, Japan. kono.yum@kmu.ac.jp.
Objectives:
The aim of this study was to evaluate the utility of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in monitoring the response to Ra-223 therapy in patients with castration-resistant prostate cancer (CRPC) and bone metastasis.
Materials And Methods:
This retrospective study included 15 patients with CRPC and bone metastases. DWIBS scans were performed at baseline and after three cycles of Ra-223 therapy. Quantitative analysis of tumor total diffusion volume (tDV) categorized patients as stable disease (DWIBS-SD), partial response (DWIBS-PR), or progressive disease (DWIBS-PD). Kaplan-Meier analysis and log-rank tests were used to assess the correlation between DWIBS findings and survival.
Results:
Of the 15 patients (median age 72 years ± 7.3), 7 (47%) were classified as DWIBS-SD, 3 (20%) as DWIBS-PR, and 5 (33%) as DWIBS-PD. DWIBS-PD group had significantly shorter survival than the DWIBS-non-PD group (P = 0.004). Despite no significant differences in age, alkaline phosphatase, prostate-specific antigen or bone metastasis volume, DWIBS-PD group had a significantly higher proportion of patients with Eastern Cooperative Oncology Group performance status score of 2 before the treatment compared to DWIBS-non-PD group (P = 0.039).
Conclusion:
DWIBS is a valuable tool for monitoring treatment response and predicting outcome in patients with CRPC undergoing Ra-223 therapy. Early intervention or treatment modification is recommended for patients with DWIBS-PD.
