Impact of neoadjuvant androgen deprivation therapy on magnetic resonance imaging features in prostate cancer before radiotherapy

Ulrika Björeland; Tufve Nyholm; Joakim Jonsson; Mikael Skorpil; Lennart Blomqvist; Sara Strandberg; Katrine Riklund; Lars Beckman; Camilla Thellenberg-Karlsson

doi:10.1016/j.phro.2021.01.004

Impact of neoadjuvant androgen deprivation therapy on magnetic resonance imaging features in prostate cancer before radiotherapy

Phys Imaging Radiat Oncol. 2021 Feb 24:17:117-123. doi: 10.1016/j.phro.2021.01.004. eCollection 2021 Jan.

Authors

Ulrika Björeland¹, Tufve Nyholm¹, Joakim Jonsson¹, Mikael Skorpil², Lennart Blomqvist², Sara Strandberg¹, Katrine Riklund¹, Lars Beckman¹, Camilla Thellenberg-Karlsson¹

Affiliations

¹ Department of Radiation Sciences, Umeå University, Umeå, Sweden.
² Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Abstract

Background and purpose: In locally advanced prostate cancer (PC), androgen deprivation therapy (ADT) in combination with whole prostate radiotherapy (RT) is the standard treatment. ADT affects the prostate as well as the tumour on multiparametric magnetic resonance imaging (MRI) with decreased PC conspicuity and impaired localisation of the prostate lesion. Image texture analysis has been suggested to be of aid in separating tumour from normal tissue. The aim of the study was to investigate the impact of ADT on baseline defined MRI features in prostate cancer with the goal to investigate if it might be of use in radiotherapy planning.

Materials and methods: Fifty PC patients were included. Multiparametric MRI was performed before, and three months after ADT. At baseline, a tumour volume was delineated on apparent diffusion coefficient (ADC) maps with suspected tumour content and a reference volume in normal prostatic tissue. These volumes were transferred to MRIs after ADT and were analysed with first-order -and invariant Haralick -features.

Results: At baseline, the median value and several of the invariant Haralick features of ADC, showed a significant difference between tumour and reference volumes. After ADT, only ADC median value could significantly differentiate the two volumes.

Conclusions: Invariant Haralick -features could not distinguish between baseline MRI defined PC and normal tissue after ADT. First-order median value remained significantly different in tumour and reference volumes after ADT, but the difference was less pronounced than before ADT.

Keywords: Androgen deprivation; GLCM; Prostate; Texture; mpMRI.