PD55-01 DUTASTERIDE AND ACTIVE SURVEILLANCE IN PROSTATE CANCER: ARE VISIBLE LESIONS LESS CONSPICUOUS AT MAGNETIC RESONANCE IMAGING? A PILOT RANDOMIZED CONTROLLED TRIAL

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance III1 Apr 2017PD55-01 DUTASTERIDE AND ACTIVE SURVEILLANCE IN PROSTATE CANCER: ARE VISIBLE LESIONS LESS CONSPICUOUS AT MAGNETIC RESONANCE IMAGING? A PILOT RANDOMIZED CONTROLLED TRIAL Francesco Giganti, Caroline Moore, Nicola Robertson, Alex Freeman, Mark Emberton, Clare Allen, and Alex Kirkham Francesco GigantiFrancesco Giganti More articles by this author , Caroline MooreCaroline Moore More articles by this author , Nicola RobertsonNicola Robertson More articles by this author , Alex FreemanAlex Freeman More articles by this author , Mark EmbertonMark Emberton More articles by this author , Clare AllenClare Allen More articles by this author , and Alex KirkhamAlex Kirkham More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2424AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Dutasteride 0.5mg daily is licensed for lower urinary tract symptoms (LUTS) in men with an enlarged prostate, and some men on active surveillance will be taking dutasteride for LUTS. This study was designed to describe the effects of daily 0.5 mg dutasteride for 6 months, compared to placebo, on men with biopsy proven prostate cancer and an MR lesion at baseline. We report here the effect of dutasteride on the conspicuity of tumor on diffusion-weighted imaging (DWI) sequences to answer the question: does dutasteride make visible lesions less conspicuous on DWI? METHODS Institutional review board approval and patient informed consent were obtained. We retrospectively analyzed 37 men, randomized to 6 months of daily dutasteride 0.5 mg (n=18) or placebo (n=19), undergoing 3T multi-parametric Magnetic Resonance Imaging (mpMRI) scans at baseline and 6 months. Images were reviewed by 2 experienced uro-radiologists in consensus blind to treatment allocation and clinical information. Mean apparent diffusion coefficient (ADC) from DWI of peripheral (PZ) and transition (TZ) zones, and MR-suspicious lesions were compared between the dutasteride and placebo groups at baseline and 6 months (T test; p < 0.05 significant). We defined the term conspicuity as the mean ADC of the PZ divided by the mean ADC of the lesion. We assessed the change in conspicuity over 6 months and analyzed the differences in the dutasteride and placebo groups. RESULTS All men had at least one visible lesion at baseline and 6 months on DWI. There were no significant differences at 6 months for ADC values in the PZ, TZ and lesions between the two groups (placebo vs dutasteride). There was a significant decrease in mean conspicuity in the dutasteride group (1.54 at baseline vs 1.38 after 6 months; p = 0.025). Changes in mean absolute tumor ADC and conspicuity between the placebo and dutasteride groups were demonstrated (- 0.03 vs 0.08, p =0.033) and (0.11 vs - 0.16, p = 0.012), respectively. There was a significant percentage increase in tumor ADC and a significant decrease in the conspicuity for the dutasteride group when compared to men in the placebo group (8.6% vs - 2.3%, p = 0.048) and (- 9.9% vs 9.3, p = 0.013), respectively. CONCLUSIONS Dutasteride reduces tumor ADC and conspicuity. A lower biopsy threshold would make sense in men who are on dutasteride for LUTS and are undergoing MRI assessment for prostate cancer. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1051 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Francesco Giganti More articles by this author Caroline Moore More articles by this author Nicola Robertson More articles by this author Alex Freeman More articles by this author Mark Emberton More articles by this author Clare Allen More articles by this author Alex Kirkham More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...