弥散加权成像在前列腺癌骨转移中的应用：检测与治疗评估。

Application of Diffusion Weighted Imaging in Prostate Cancer Bone Metastasis: Detection and Therapy Evaluation.

机构信息

Department of Radiology, Medical Imaging Key Laboratory of Sichuan Province, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China.

出版信息

Anticancer Agents Med Chem. 2021;21(15):1950-1956. doi: 10.2174/1871520621666210118092641.

DOI:10.2174/1871520621666210118092641

PMID:33461473

Abstract

BACKGROUND

Bone metastasis is one of the most common complications of Prostate Cancer (PCa). The detection of distal bone metastasis at the time of initial PCa diagnosis is valuable for the determination of therapeutic methods and for the prognosis of PCa. Many current therapeutic methods target PCa bone metastasis, but no uniform evaluation standard for therapeutic efficacy has been established; in addition, traditional therapeutic evaluation standards that rely on changes in the measured tumor volume are quite controversial. In clinical practice, the volumes of some tumors often change nonsignificantly at the early stage of therapy (especially targeted therapy), while the volumes of other tumors, such as metastatic bone lesions, are difficult to measure. Diffusion-Weighted Imaging (DWI) not only reflects the diffusion characteristics of tissues but can also allow the analysis of microstructural and functional changes in tissues. Therefore, DWI is suitable for evaluations of early responses to tumor therapy.

OBJECTIVE

This study mainly reviews the principle of DWI and its progress in the detection and therapy evaluation of PCa bone metastasis.

METHODS

PubMed was searched to identify eligible articles up to December 26, 2020. The keywords of the analysis included DWI, PCa, bone metastasis, therapeutic response, targeted therapy, Bone Scintigraphy (BS), Positron Emission Tomography/Computed Tomography (PET/CT) and metastatic Castration-Resistant Prostate Cancer (mCRPC).

RESULTS

This review based on collected articles achieved an imaging biomarker for detection and therapy evaluation of PCa bone metastasis.

CONCLUSION

DWI is a promising imaging method for the detection and therapeutic evaluation of PCa bone metastases.

摘要

背景

骨转移是前列腺癌（PCa）最常见的并发症之一。在初始 PCa 诊断时检测远处骨转移对于确定治疗方法和 PCa 的预后具有重要价值。目前许多治疗方法针对 PCa 骨转移，但尚未建立统一的疗效评估标准；此外，依赖测量肿瘤体积变化的传统治疗评估标准存在很大争议。在临床实践中，一些肿瘤的体积在治疗早期（尤其是靶向治疗）往往变化不大，而其他肿瘤的体积，如转移性骨病变，难以测量。弥散加权成像（DWI）不仅反映了组织的扩散特性，还可以分析组织的微观结构和功能变化。因此，DWI 适用于评估肿瘤治疗的早期反应。