Advanced Radiotherapy Group, Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Belfast, BT97 1NN, United Kingdom.
Department of Imaging Services, Belfast Health & Social Care Trust, Belfast, BT9 7AB, United Kingdom.
Br J Radiol. 2024 Mar 28;97(1156):794-802. doi: 10.1093/bjr/tqae005.
The aim of this study was to generate an objective method to describe MRI data to assess response in the vertebrae of patients with metastatic hormone sensitive prostate cancer (mHSPC), treated with external beam radiation therapy and systemic therapy with Radium-223 and to correlate changes with clinical outcomes.
Three sets of whole-body MRI (WBMRI) images were utilized from 25 patients from the neo-adjuvant Androgen Deprivation Therapy pelvic Radiotherapy and RADium-223 (ADRRAD) clinical trial: MRI1 (up to 28 days before Radium-223), MRI2, and MRI3 (2 and 6 months post completion of Radium-223). Radiological response was assessed based on post baseline MRI images. Vertebrae were semi-automatically contoured in the sagittal T1-weighted (T1w) acquisitions, MRI intensity was measured, and spinal cord was used to normalize the measurements. The relationship between MRI intensity vs time to biochemical progression and radiology response was investigated. Survival curves were generated and splitting measures for survival and biochemical progression investigated.
Using a splitting measure of 1.8, MRI1 was found to be a reliable quantitative indicator correlating with overall survival (P = 0.023) and biochemical progression (P = 0.014). MRI (3-1) and MRI (3-2) were found to be significant indicators for patients characterized by progressive/non-progressive disease (P = 0.021, P = 0.004) and biochemical progression within/after 12 months (P = 0.007, P = 0.001).
We have identified a potentially useful objective measure of response on WBMRI of vertebrae containing bone metastases in mHSPC which correlates with survival/progression (prognostic) and radiology response (predictive).
Measurements of T1w WBMRI normalized intensity may allow identifying potentially useful response biomarkers correlating with survival, radiological response and biochemical progression.
本研究旨在生成一种客观方法来描述 MRI 数据，以评估接受外照射放射治疗和镭-223 系统治疗的转移性激素敏感前列腺癌（mHSPC）患者脊柱的反应，并将变化与临床结果相关联。
从 neo-adjuvant Androgen Deprivation Therapy pelvic Radiotherapy and RADium-223（ADRRAD）临床试验中的 25 名患者中使用了三组全身 MRI（WBMRI）图像：MRI1（在镭-223 之前最多 28 天）、MRI2 和 MRI3（在镭-223 完成后 2 个月和 6 个月）。根据基线后 MRI 图像评估放射学反应。在矢状 T1 加权（T1w）采集物中半自动勾勒椎体，测量 MRI 强度，并使用脊髓对测量值进行归一化。研究了 MRI 强度与生化进展和放射学反应之间的关系。生成生存曲线，并研究了用于生存和生化进展的分割措施。
使用 1.8 的分割措施，发现 MRI1 是与总生存（P=0.023）和生化进展（P=0.014）相关的可靠定量指标。发现 MRI（3-1）和 MRI（3-2）是具有进行性/非进行性疾病特征的患者的显著指标（P=0.021，P=0.004）和 12 个月内/后生化进展（P=0.007，P=0.001）。
我们已经确定了一种在 mHSPC 中包含骨转移的椎体的 WBMRI 上反应的潜在有用的客观测量方法，该方法与生存/进展（预后）和放射学反应（预测）相关。
T1w WBMRI 归一化强度的测量值可能允许识别与生存、放射学反应和生化进展相关的潜在有用的反应生物标志物。
