Aims and objectives
Advanced prostate cancer (APCa) is highly malignant and impacts the quality of life in patients worldwide[1].
Lymph nodes and bone are the most common sites for metastases of prostate cancer [2].
In most cases APCa becomes androgen independent which significantly deteriorates the prognosis for this patient[3].
Metastatic castration resistant prostate cancer (mCRPC) is a diagnostic challenge to the physician.Unfortunately,
mCRPC is does not respond well to treatment.
Effective screening should therefore be applied to identify and differentiate the lesions,
especially in the bone at an...
Methods and materials
In our prospective pilot single center study we included 10 consecutive mCRPC patients with a suspicion of bone metastases on imaging.
The study was conducted in the Radboud Medical University (Nijmegen,
Netherlands) from February 2018 untill August 2018.
All patients had a full clinical examination,
MRI of the pelvic bone and lumbar spine,
PSMA-PET/CT,
and cone beam CT-guided bone biopsy.
Study inclusion and exclusion criteria are represented in Fig.1.
Our study was approved by the local ethical committee and all patients were informed about research...
Results
Ten bone biopsies were performed on 10 patients (median age 64 years; range 57–71years).
Nine (90%) of these 10 biopsies were representative and positive for tumor cells.
One biopsy (10%) was representative and negative for tumor cells.
However,
we should note that this lesion was PSMA positive and DWI/ADC negative (in the other cases all lesions were PSMA and DWI/ADC positive).
Less fat component was found in metastatic bone lesions in comparison with normal bone: median of the FF in positive bone biopsies was 14%;...
Conclusion
MR-molecular imaging is a powerful technique that could improve the accuracy of non-invasive detection and differentiation of bone lesions in CRPC patients.
Further studies with a higher amount of patients are needed in order to develop reliable MR imaging criteria for CRPC bone metastases assessment.
Personal information
Dr.
Filipp Kossov
e-mail:
[email protected]
Radiology Department,
N.N.
Blohin Russian National ResearchCenter of Oncology
References
1.
Halabi S,
Kelly WK,
Ma H,и др.Meta-analysis evaluating the impact of site of metastasis on overall survival in men with castration-resistant prostate cancer.J Clin Oncol2016;34:1652–9.
doi:10.1200/JCO.2015.65.7270
2.
Cook GJR,
Azad G,
Padhani AR.
Bone imaging in prostate cancer: the evolving roles of nuclear medicine and radiology.
Clin.
Transl.
Imaging.
2016;4:439–47.
doi:10.1007/s40336-016-0196-5
3.
James ND,
Spears MR,
Clarke NW,и др.Survival with newly diagnosed metastatic prostate cancer in the docetaxel era: Data from 917 patients in the control arm of the STAMPEDE Trial (MRC PR08,
CRUK/06/019).Eur...