TY - JOUR
T1 - Locally advanced prostate cancer: three-dimensional magnetic resonance spectroscopy to monitor prostate response to therapy.
AU - Valentini, Anna Lia
AU - Gui, Benedetta
AU - D'Agostino, Giuseppe Roberto
AU - Mattiucci, Gian Carlo
AU - Clementi, Valeria
AU - Di Molfetta, Ippolita Valentina
AU - Bonomo, Pierluigi
AU - Mantini, Giovanna
PY - 2012
Y1 - 2012
N2 - Purpose: To correlate results of three-dimensional magnetic resonance spectroscopic imaging
(MRSI) with prostate-specific antigen (PSA) levels and time since external beam irradiation
(EBRT) in patients treated with long-term hormone therapy (HT) and EBRT for locally
advanced disease to verify successful treatment by documenting the achievement of metabolic
atrophy (MA).
Methods and Materials: Between 2006 and 2008, 109 patients were consecutively enrolled. MA
was assessed by choline and citrate peak area-to-noise-ratio <5:1. Cancerous metabolism (CM)
was defined by choline-to-creatine ratio >1.5:1 or choline signal-to-noise-ratio >5:1. To test the
strength of association between MRSI results and the time elapsed since EBRT (TEFRT), PSA
levels, Gleason score (GS), and stage, logistic regression (LR) was performed. p value <0.05
was statistically significant. The patients’ outcomes were verified in 2011.
Results: MRSI documented MA in 84 of 109 and CM in 25 of 109 cases. LR showed that
age, GS, stage, and initial and recent PSA had no significant impact on MRSI results which
were significantly related to PSA values at the time of MRSI and to TEFRT. Patients were
divided into three groups according to TEFRT: <1 year, 1e2 years, and >2 years. MA
was detected in 54.1% of patients of group 1, 88.9% of group 2, and in 94.5% of group
3 (100% when PSA nadir was reached). CM was detected in 50% of patients with reached
PSA nadir in group 1. Local relapse was found in 3 patients previously showing CM at long
TEFRT.
Conclusion: MA detection, indicative of successful treatment because growth of normal or
abnormal cells cannot occur without metabolism, increases with decreasing PSA levels and
increasing time on HT after EBRT. This supports long-term HT in advanced prostate cancer.
Larger study series are needed to assess whether MRSI could predict local relapse by detecting
CM at long TEFRT. 2012 Elsevier Inc
AB - Purpose: To correlate results of three-dimensional magnetic resonance spectroscopic imaging
(MRSI) with prostate-specific antigen (PSA) levels and time since external beam irradiation
(EBRT) in patients treated with long-term hormone therapy (HT) and EBRT for locally
advanced disease to verify successful treatment by documenting the achievement of metabolic
atrophy (MA).
Methods and Materials: Between 2006 and 2008, 109 patients were consecutively enrolled. MA
was assessed by choline and citrate peak area-to-noise-ratio <5:1. Cancerous metabolism (CM)
was defined by choline-to-creatine ratio >1.5:1 or choline signal-to-noise-ratio >5:1. To test the
strength of association between MRSI results and the time elapsed since EBRT (TEFRT), PSA
levels, Gleason score (GS), and stage, logistic regression (LR) was performed. p value <0.05
was statistically significant. The patients’ outcomes were verified in 2011.
Results: MRSI documented MA in 84 of 109 and CM in 25 of 109 cases. LR showed that
age, GS, stage, and initial and recent PSA had no significant impact on MRSI results which
were significantly related to PSA values at the time of MRSI and to TEFRT. Patients were
divided into three groups according to TEFRT: <1 year, 1e2 years, and >2 years. MA
was detected in 54.1% of patients of group 1, 88.9% of group 2, and in 94.5% of group
3 (100% when PSA nadir was reached). CM was detected in 50% of patients with reached
PSA nadir in group 1. Local relapse was found in 3 patients previously showing CM at long
TEFRT.
Conclusion: MA detection, indicative of successful treatment because growth of normal or
abnormal cells cannot occur without metabolism, increases with decreasing PSA levels and
increasing time on HT after EBRT. This supports long-term HT in advanced prostate cancer.
Larger study series are needed to assess whether MRSI could predict local relapse by detecting
CM at long TEFRT. 2012 Elsevier Inc
KW - Magnetic Resonance
KW - Magnetic Resonance
UR - http://hdl.handle.net/10807/102916
U2 - 10.1016/j.ijrobp.2011.12.089
DO - 10.1016/j.ijrobp.2011.12.089
M3 - Article
SN - 0360-3016
VL - 84
SP - 719
EP - 724
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
ER -
