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Title: Locally Advanced Prostate Cancer: Three-Dimensional Magnetic Resonance Spectroscopy to Monitor Prostate Response to Therapy

Abstract

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, 1-2 years, and >2 years. MA was detected in 54.1% of patients of group 1, 88.9%more » 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.« less

Authors:
 [1];  [1]; ;  [2];  [3];  [1];  [4];  [2]
  1. Department of Bioimaging and Radiological Sciences, Section of Radiology, Universita Cattolica del Sacro Cuore di Roma, Milan (Italy)
  2. Department of Bioimaging and Radiological Sciences, Section of Radiotherapy, Universita Cattolica del Sacro Cuore di Roma, Milan (Italy)
  3. Clinical Science Development Group, GE Healthcare, Milan (Italy)
  4. OU Clinic Radiobiology, I.F.C.A. Florence (Italy)
Publication Date:
OSTI Identifier:
22149578
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ATROPHY; CHOLINE; CITRATES; CREATINE; HORMONES; IRRADIATION; MAGNETIC RESONANCE; METABOLISM; NEOPLASMS; PATIENTS; PROSTATE; SIGNAL-TO-NOISE RATIO; SPECTROSCOPY; THERAPY

Citation Formats

Valentini, Anna Lia, E-mail: alvalentini@rm.unicatt.it, Gui, Benedetta, D'Agostino, Giuseppe Roberto, Mattiucci, Giancarlo, Clementi, Valeria, Di Molfetta, Ippolita Valentina, Bonomo, Pierluigi, and Mantini, Giovanna. Locally Advanced Prostate Cancer: Three-Dimensional Magnetic Resonance Spectroscopy to Monitor Prostate Response to Therapy. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.089.
Valentini, Anna Lia, E-mail: alvalentini@rm.unicatt.it, Gui, Benedetta, D'Agostino, Giuseppe Roberto, Mattiucci, Giancarlo, Clementi, Valeria, Di Molfetta, Ippolita Valentina, Bonomo, Pierluigi, & Mantini, Giovanna. Locally Advanced Prostate Cancer: Three-Dimensional Magnetic Resonance Spectroscopy to Monitor Prostate Response to Therapy. United States. doi:10.1016/J.IJROBP.2011.12.089.
Valentini, Anna Lia, E-mail: alvalentini@rm.unicatt.it, Gui, Benedetta, D'Agostino, Giuseppe Roberto, Mattiucci, Giancarlo, Clementi, Valeria, Di Molfetta, Ippolita Valentina, Bonomo, Pierluigi, and Mantini, Giovanna. Thu . "Locally Advanced Prostate Cancer: Three-Dimensional Magnetic Resonance Spectroscopy to Monitor Prostate Response to Therapy". United States. doi:10.1016/J.IJROBP.2011.12.089.
@article{osti_22149578,
title = {Locally Advanced Prostate Cancer: Three-Dimensional Magnetic Resonance Spectroscopy to Monitor Prostate Response to Therapy},
author = {Valentini, Anna Lia, E-mail: alvalentini@rm.unicatt.it and Gui, Benedetta and D'Agostino, Giuseppe Roberto and Mattiucci, Giancarlo and Clementi, Valeria and Di Molfetta, Ippolita Valentina and Bonomo, Pierluigi and Mantini, Giovanna},
abstractNote = {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, 1-2 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.},
doi = {10.1016/J.IJROBP.2011.12.089},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}