Academic Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center, Lille, France.
CRIStAL laboratory, UMR CNRS 9189, University Lille 1, Villeneuve d'Ascq, France.
Sci Rep. 2018 Jul 10;8(1):10407. doi: 10.1038/s41598-018-28817-9.
We evaluated the feasibility of using the kinetic of diffusion-weighted MRI (DWI) and the normalized apparent coefficient diffusion (ADC) map value as an early biomarker in patients treated by external beam radiotherapy (EBRT). Twelve patients were included within the frame of a multicenter phase II trial and treated for intermediate risk prostate cancer (PCa). Multiparametric MRI was performed before treatment (M0) and every 6 months until M24. Association between nADC and PSA or PSA kinetic was evaluated using the test of nullity of the Spearman correlation coefficient. The median rates of PSA at the time of diagnosis, two years and four years after EBRT were 9.29 ng/ml (range from 5.26 to 17.67), 0.68 ng/ml (0.07-2.7), 0.47 ng/ml (0.09-1.39), respectively. Median nADC increased from 1.14 × 10 mm/s to 1.59 × 10 mm/s between M0 and M24. Only one patient presented a decrease of nADC (1.35 × 10 mm/s and 1.11 × 10 mm/s at M0 and M12 respectively). The increase in nADC at M6 was correlated with PSA decrease at M18, M24 and M30 (p < 0.05). The increase in nADc at M12 was correlated with PSA decrease at M36 (p = 0.019). Early nADC variation were correlated with late PSA decrease for patients with PCa treated by EBRT.
我们评估了使用扩散加权磁共振成像（DWI）的扩散系数变化率和标准化表观扩散系数（ADC）图值作为接受外照射放射治疗（EBRT）的患者的早期生物标志物的可行性。在一项多中心 II 期试验中，纳入了 12 名患者，并对其进行了中间风险前列腺癌（PCa）的治疗。在治疗前（M0）和每 6 个月进行多参数 MRI 检查，直到 M24。使用 Spearman 相关系数检验来评估 nADC 与 PSA 或 PSA 动力学之间的关联。EBRT 后诊断时、两年和四年时的 PSA 中位数率分别为 9.29ng/ml（范围为 5.26-17.67）、0.68ng/ml（0.07-2.7）、0.47ng/ml（0.09-1.39）。nADC 中位数从 M0 到 M24 从 1.14×10mm/s 增加到 1.59×10mm/s。只有一名患者的 nADC 降低（M0 和 M12 时分别为 1.35×10mm/s 和 1.11×10mm/s）。M6 时 nADC 的增加与 M18、M24 和 M30 时 PSA 的降低相关（p<0.05）。M12 时 nADC 的增加与 M36 时 PSA 的降低相关（p=0.019）。EBRT 治疗的 PCa 患者的早期 nADC 变化与晚期 PSA 降低相关。
