MONITORING HORMONAL ABLATION OF PROSTATE CANCER BY MRSI

雄激素剥夺疗法(ADT)越来越多地被用作局部前列腺癌(PCa)患者的主要和新辅助治疗方法。我们最近的研究表明，三维磁共振波谱成像(MRSI)提供的代谢信息可以提高磁共振成像(MRI)在前列腺癌治疗前和治疗后识别的特异性。然而，我们的初步数据也表明，ADT引起的解剖和代谢萎缩是时间依赖性的，在治疗后的某些时间，MRI/MRSI联合评估残留/复发癌症的能力可能会降低。因此，需要确定激素治疗后解剖和代谢萎缩的时间进程。手术标本的初步质子魔角旋转核磁共振(1H MAS-NMR)波谱研究也发现了几个代谢变化，这些变化可能会进一步提高MRSI在ADT后识别癌症的特异性。在这项研究中，一系列活体MRI/MRSI数据和从活检样本获得的1H MAS-核磁共振数据将与临床数据相结合，以检查接受ADT的患者发生的解剖和代谢变化。这项工作的目标是改善激素消融后癌症的MRI/MRSI评估，并更好地了解ADT的生化后果。这项工作的临床重要性，再加上Swanson博士对将核磁共振应用于生物学问题的浓厚兴趣和背景，以及我们在加州大学旧金山分校拥有的在前列腺MRI/MRSI方面的丰富经验，使这一主题成为他博士后研究的理想主题。

Androgen deprivation therapy (ADT) is being increasingly used as both a primary and neoadjuvant therapy for patients with localized prostate cancer (PCa). Our recent studies have demonstrated that the metabolic information provided by 3D MR spectroscopic imaging (MRSI) can improve the specificity of magnetic resonance imaging (MRI) in identifying prostate cancer prior to and after therapy. However, our preliminary data also indicate that the anatomic and metabolic atrophy induced by ADT is duration dependent and the ability of combined MRI/MRSI to assess the presence of residual/recurrent cancer can be reduced at certain times after therapy. Therefore, the time-course of anatomic and metabolic atrophy following hormone therapy needs to be established. Preliminary proton magic angle spinning nuclear magnetic resonance (1H MAS-NMR) spectroscopy studies of surgical specimens have also identified several metabolic changes that may further increase the specificity of MRSI for the identification of cancer after ADT. In this fellowship, serial in vivo MRI/MRSI data and 1H MAS-NMR data obtained from biopsy samples will be combined with clinical data to examine the anatomic and metabolic changes that occur in patients undergoing ADT. The goal of this work is to improve the MRI/MRSI assessment of cancer after hormone ablation and to better understand the biochemical consequences of ADT. The clinical importance of this work combined with Dr Swanson's strong interest and background in the application of NMR to biological questions and the extensive experience in MRI/MRSI of prostate that we have at UCSF makes this an ideal topic for his post-doctoral fellowship.