A feasibility study evaluating the functional diffusion map as a predictive imaging biomarker for detection of treatment response in a patient with metastatic prostate cancer to the bone
A feasibility study evaluating the functional diffusion map as a predictive imaging biomarker for detection of treatment response in a patient with metastatic prostate cancer to the bone
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DOI：
10.1593/neo.07954
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发表时间：
2007-12-01
期刊：
影响因子：
4.8
通讯作者：
Ross, Brian D.
中科院分区：
文献类型：
--
作者：
Lee, Kuei C.;Bradley, Deborah A.;Ross, Brian D.
前列腺癌（PCa）是美国男性中最常见的诊断癌症，其中一部分不可避免地表现为骨转移性疾病。在评估转移性PCa的新治疗方法时，一个公认的局限性是无法使用成像来客观评估缓解治疗。在这项研究中，我们评估了临床上转换功能性扩散图（FDM）成像生物标志物的可行性，以量化骨转移性前列腺癌伴骨转移患者骨肿瘤缓解的时空效应。在治疗前和治疗开始后2周和8周再次使用MRI扫描开始治疗的患者，以量化肿瘤扩散值的变化。确定了3处转移性病灶进行fDM分析，所有这些病灶均显示在2周时弥散值早期增加，在治疗开始后8周进一步增加。这一发现与患者的前列腺特异性抗原（PSA）水平降低相关，提示患者反应。治疗后获得的CT、骨扫描和解剖MRI图像无法提供治疗有效性评估的信息。本研究介绍了随时间推移在骨病变中进行FDM测量的可行性，并表明FDM值的变化与治疗反应一致。因此，FDM成像生物标志物可提供可量化的治疗终点，以评估转移性骨癌患者的缓解。
Prostate cancer (PCa) is the most commonly diagnosed cancer in American men with a subset inevitably presenting with metastatic disease to the bone. A well-recognized limitation in evaluating new treatments for metastatic PCa is the inability to use imaging to objectively assess response therapy. In this study, we evaluated the feasibility of clinically translating the functional diffusion map (fDM) imaging biomarker for quantifying the spatiotemporal effects of bone tumor response in a patient treated for metastatic PCa with bone metastases. A patient beginning therapy was scanned using MRI before treatment and again at 2 and 8 weeks post-treatment initiation to quantify changes in tumor diffusion values. Three metastatic lesions were identified for fDM analysis, all of which all demonstrated an early increase in diffusion values at 2 weeks, which increased further at 8 weeks post-treatment initiation. This finding correlated with a decrease in the patient's prostate-specific antigen (PSA) levels suggestive of patient response. CT, bone scans, and anatomic MRI images obtained posttreatment were found to be uninformative for the assessment of treatment effectiveness. This study presents the feasibility of fDM measurements in osseous lesions over time and shows that changes in fDM values were consistent with therapeutic response. Thus, the fDM imaging biomarker may provide a quantifiable therapeutic endpoint to assess response in patients with metastatic bone cancer.