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Effects of Androgen Deprivation on Prostatic Morphology and Vascular Permeability Evaluated with MR Imaging¹

¹ From the CRC Clinical Magnetic Resonance Research Group and Academic Department of Radiotherapy (D.P.D.), Institute of Cancer Research and Royal Marsden NHS Trust, Sutton, Surrey, England. From the 1998 RSNA scientific assembly. Received Jan 7, 2000; revision requested Mar 2; revision received May 30; accepted Jun 28. Supported by CRC grant no. SP1780-0103, the Bob Champion Cancer Trust, and the NHS Executive. Address correspondence to A.R.P., Paul Strickland Cancer Center, Mount Vernon Hospital, Rickmansworth Rd, Northwood, Middlesex HA6 2RN, United Kingdom (e-mail: anwar_padhani@fsnet.co.uk).   The views expressed in this article are those of the authors and not necessarily those of the NHS Executive.

PURPOSE: To assess magnetic resonance (MR) measures of vascular permeability of prostate cancer treated with androgen deprivation and to correlate these with morphologic appearances and serum prostate-specific antigen (PSA) levels.

MATERIALS AND METHODS: MR examinations in 56 consecutive patients with prostate cancer were performed before and after luteinizing hormone–releasing hormone analog treatment. T2-weighted and contrast medium–enhanced T1-weighted MR images were obtained. Pre- and posttreatment comparisons of morphologic features, glandular volume, and enhancement-related parameters (capillary permeability, leakage space, gadolinium accumulation) were made.

RESULTS: Fifty-five tumors were seen before treatment; 42, after treatment. Signal intensity in the peripheral zone and seminal vesicles decreased on T2-weighted images in 42 (75%) and 25 (45%) patients, respectively. Median volume in tumor decreased by 65% (95% CI: 55%, 76%); in central gland, by 30% (95% CI: 25%, 35%). Reductions in tumor permeability (P < .001) and changes in washout patterns were observed (P < .001). Tumor permeability reductions coincided with a decrease in serum PSA levels in 91% of patients. A weak correlation between tumor permeability and volume change was seen (r = 0.55, P = .04). Reductions in peripheral zone (P < .001) and central gland (P = .009) permeability were noted.

CONCLUSION: Androgen deprivation decreases tumor volume and vascular permeability and impairs detection of prostate cancers. Use of MR estimates of permeability may be an additional way of assessing prostatic tumor response to antiandrogen treatment.

Index terms: Hormones • Magnetic resonance (MR), contrast enhancement, 84.12143 • Prostate neoplasms, 844.32 • Prostate neoplasms, MR, 84.121411, 84.121412, 84.12143 • Prostate neoplasms, therapy

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