MP11-03 PRIMARY TUMOR RESPONSE TO NEXT GENERATION ANTI-ANDROGEN THERAPY ASSESSED BY PRE-POST TREATMENT MRI PRIOR TO RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II1 Apr 2018MP11-03 PRIMARY TUMOR RESPONSE TO NEXT GENERATION ANTI-ANDROGEN THERAPY ASSESSED BY PRE-POST TREATMENT MRI PRIOR TO RADICAL PROSTATECTOMY Chad A. Reichard, Tharakeswala K. Bathala, Justin R. Gregg, Mary Achim, Janet Kukreja, Eleni Efstathiou, John W. Davis, and Brian F. Chapin Chad A. ReichardChad A. Reichard More articles by this author , Tharakeswala K. BathalaTharakeswala K. Bathala More articles by this author , Justin R. GreggJustin R. Gregg More articles by this author , Mary AchimMary Achim More articles by this author , Janet KukrejaJanet Kukreja More articles by this author , Eleni EfstathiouEleni Efstathiou More articles by this author , John W. DavisJohn W. Davis More articles by this author , and Brian F. ChapinBrian F. Chapin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.369AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pre-treatment predictors of local therapy benefit in advanced prostate cancer (aPCa) are of interest. We aimed to describe differences in diffusion weighted imaging characteristics after treatment with ADT and examine whether these changes were associated with pT stage post radical prostatectomy (RP). METHODS 42 pts with aPCa treated with pre-surgical ADT from 2011-2017 were reviewed (16 pts treated with abi+enza, 7 pts treated with abi+LHRH agonist, and 19 pts treated with LHRH agonist/antagonist alone). All pts had 1.5T MRI with endorectal coil pre-ADT initiation and then had repeat MRI prior to RP. Dominant lesion mapped on RP pathology report was correlated to the lesion seen on MR, and ADC (apparent diffusion coefficient) values of the tumor and benign tissue were recorded. We compared pre-post ADC values in tumor, normal prostate tissue and examined for association of changes in imaging parameters and pT stage. RESULTS Median PSA was (16.8 IQR 9.2-28.1) and pt characteristics are summarized in table. Mean tumor ADC was larger after ADT treatment 1111+/-233 (10-6mm2/sec) vs prior to ADT 800+/-120 (10-6mm2/sec) p<.01. Mean ADC of normal transition zone and normal peripheral zone were both decreased post ADT (1363+/-160 to 1222+/-171 and 1612+/-256 to 1511+/-215, both p<.01). Mean largest tumor cross sectional area was decreased after ADT (3.31+/-3.01 cm2 to 1.44+/-1.21 cm2, p<.01). Mean prostate volume was also decreased after ADT (49.4+/-24.9 cm3 to 25.3+/-15.9cm3, p<.01). The mean post ADT increase in tumor ADC was 32% for patients treated LHRH agonist/antagonist alone compared to 53% for patients treated with abi +/- enza (p=0.039). There was no relation between relative tumor area post-treatment (p=0.34) or >50% change in ADC post-treatment (p=0.27) and >= pT3b disease. CONCLUSIONS This is the first report to our knowledge of prostate MRI prior to and after combination next generation anti-androgen treatment. Larger increases in post treatment ADC values were seen in patients treated with abi +/- enza compared to LHRH agonist/antagonist alone. While there was no association between changes in DWI imaging characteristics and worse pathologic outcome, further correlation with clinical outcomes may demonstrate imaging findings predictive of benefit from local therapy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e127-e128 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Chad A. Reichard More articles by this author Tharakeswala K. Bathala More articles by this author Justin R. Gregg More articles by this author Mary Achim More articles by this author Janet Kukreja More articles by this author Eleni Efstathiou More articles by this author John W. Davis More articles by this author Brian F. Chapin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...