Prostate gland: MR imaging appearance after vascular targeted photodynamic therapy with palladium-bacteriopheophorbide
Prostate gland: MR imaging appearance after vascular targeted photodynamic therapy with palladium-bacteriopheophorbide
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DOI：
10.1148/radiol.2441060398
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发表时间：
2007-07-01
期刊：
影响因子：
19.7
通讯作者：
Trachtenberg, John
中科院分区：
文献类型：
--
作者：
Haider, Masoom A.;Davidson, Sean R. H.;Trachtenberg, John
目的：前瞻性评价体外放射治疗后局部复发癌血管靶向光动力治疗（VTP）后前列腺及前列腺周围组织的磁共振成像表现。材料和方法：所有患者均获得知情同意，并获得所有参与机构伦理审查委员会的批准。作为前瞻性I/ II期试验的一部分，在基线和VTP后1周、4周和6个月对25名男性（年龄范围58 - 83岁，平均年龄73岁）进行非增强T2加权和动态钆增强T1加权MR成像检查。磁共振显示的坏死百分率定义为VTP术后1周非增强性前列腺组织的体积除以前列腺体积。记录前列腺内、外坏死的形态。Pearson相关系数用于检验坏死与前列腺特异性抗原水平的相关性。结果：治疗后1周的对比剂增强T1加权MR图像显示所有患者出现坏死。25例患者中有21例治疗边缘不规则。T2加权图像显示没有明确的治疗界限。前列腺外坏死22例累及耻骨直肠肌或提肛肌，12例累及闭孔内肌，3例累及前列腺周围静脉，4例累及耻骨骨髓，9例累及直肠前壁。所有患者的神经血管束似乎都幸免。在4周（r = 0.41, P = 0.04）和12周（r = 0.45, P = 0.02）时，MR显示的前列腺内坏死百分比与前列腺特异性抗原水平（从基线）下降百分比相关。结论：磁共振增强成像显示前列腺内边缘不规则的治疗效果。这一发现提示了不同组织对含磷磷钯的VTP的敏感性。(c) RSNA， 2007年。
Purpose: To prospectively evaluate the magnetic resonance ( MR) imaging appearance of the prostate and periprostatic tissues after vascular targeted photodynamic therapy ( VTP) with palladium- bacteriopheophorbide for locally recurrent carcinoma after external beam radiation therapy.Materials and Methods: Informed consent was obtained from all patients, and approval was obtained from the ethics review boards of all participating institutions. Nonenhanced T2- weighted and dynamic gadolinium- enhanced T1- weighted MR imaging examinations were performed at baseline and 1 week, 4 weeks, and 6 months after VTP in 25 men ( age range, 58 - 83 years; mean age, 73 years) as part of a prospective phase I/ II trial. Percentage of MR- depicted necrosis was defined as the volume of nonenhancing prostatic tissue 1 week after VTP divided by the volume of the prostate. Patterns of intra- and extraprostatic necrosis were recorded. Pearson correlation coefficients were used to test correlations between necrosis and prostate- specific antigen level.Results: Contrast material - enhanced T1- weighted MR images obtained 1 week after therapy showed necrosis in all patients. Treatment margins were irregular in 21 of 25 patients. T2- weighted images showed no clear treatment boundaries in any patient. Extraprostatic necrosis involved the puborectalis or levator ani muscles in 22, obturator internus muscle in 12, periprostatic veins in three, pubic bone marrow in four, and anterior rectal wall in nine of the 25 patients. The neurovascular bundle appeared to be spared in all patients. Percentage of MR- depicted intraprostatic necrosis was correlated with percentage decrease in prostate- specific antigen level ( from baseline) at 4 weeks ( r = 0.41, P = .04) and 12 weeks ( r = 0.45, P = .02).Conclusion: Contrast- enhanced MR imaging depicts irregular margins of intraprostatic treatment effect. This finding suggests varied tissue sensitivities to VTP with palladium- bacteriopheophorbide. (c) RSNA, 2007.