Antivascular Effects of Neoadjuvant Androgen Deprivation for Prostate Cancer: An In Vivo Human Study Using Susceptibility and Relaxivity Dynamic MRI

Journal Article · Fri Jul 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.02.060· OSTI ID:21587556

Alonzi, Roberto ^[1]; Padhani, Anwar R; Taylor, N Jane ^[2]; Collins, David J; D'Arcy, James A ^[3]; Stirling, J James ^[2]; Saunders, Michele I; Hoskin, Peter J ^[1]

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1. Marie Curie Research Wing, Mount Vernon Cancer Centre, Northwood (United Kingdom)
2. Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood (United Kingdom)
3. CRUK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust, Sutton (United Kingdom)

Purpose: The antivascular effects of androgen deprivation have been investigated in animal models; however, there has been minimal investigation in human prostate cancer. This study tested the hypothesis that androgen deprivation causes significant reductions in human prostate tumor blood flow and the induction of hypoxia at a magnitude and in a time scale relevant to the neoadjuvant setting before radiotherapy. Methods and Materials: Twenty patients were examined, each with five multi-parameter magnetic resonance imaging scans: two scans before the commencement of androgen suppression, one scan after 1 month of hormone treatment, and two further scans after 3 months of therapy. Quantitative parametric maps of the prostate informing on relative blood flow (rBF), relative blood volume (rBV), vascular permeability (transfer constant [K{sup trans}]), leakage space (v{sub e}) and blood oxygenation (intrinsic relaxivity [R{sub 2}*]) were calculated. Results: Tumor blood volume and blood flow decreased by 83% and 79%, respectively, in the first month (p < 0.0001), with 74% of patients showing significant changes. The proportion of individual patients who achieved significant changes in T1 kinetic parameter values after 3 months of androgen deprivation for tumor measurements was 68% for K{sup trans} and 53% for v{sub e} By 3 months, significant increases in R{sub 2}* had occurred in prostate tumor, with a rise of 41.1% (p < 0.0001). Conclusions: Androgen deprivation induces profound vascular collapse within 1 month of starting treatment. Increased R{sub 2}* in regions of prostate cancer and a decrease in blood volume suggest a reduction in tumor oxygenation.

• OSTI ID: 21587556
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2010.02.060; PII: S0360-3016(10)00449-9; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
ANDROGENS
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BLOOD FLOW
NEOPLASMS
NMR IMAGING
PROSTATE
RADIOTHERAPY
ANDROSTANES
BIOLOGICAL MATERIALS
BODY
BODY FLUIDS
DIAGNOSTIC TECHNIQUES
DISEASES
GLANDS
HORMONES
MALE GENITALS
MATERIALS
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
RADIOLOGY
STEROID HORMONES
STEROIDS
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