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

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. This study mainly reviews the principle of DWI and its progress in the detection and therapy evaluation of PCa bone metastasis. 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). This review based on collected articles achieved an imaging biomarker for detection and therapy evaluation of PCa bone metastasis. DWI is a promising imaging method for the detection and therapeutic evaluation of PCa bone metastases.

Gong XQ ，Tao YY ，Wang R ，Liu N ，Huang XH ，Zheng J ，Yang C ，Yang L ，Zhang XM ... -  《-》

More advantages in detecting bone and soft tissue metastases from prostate cancer using (18)F-PSMA PET/CT.

Pianou NK ，Stavrou PZ ，Vlontzou E ，Rondogianni P ，Exarhos DN ，Datseris IE ... -  《Hellenic Journal of Nuclear Medicine》

Diffusion-weighted Imaging as a Treatment Response Biomarker for Evaluating Bone Metastases in Prostate Cancer: A Pilot Study.

Perez-Lopez R ，Mateo J ，Mossop H ，Blackledge MD ，Collins DJ ，Rata M ，Morgan VA ，Macdonald A ，Sandhu S ，Lorente D ，Rescigno P ，Zafeiriou Z ，Bianchini D ，Porta N ，Hall E ，Leach MO ，de Bono JS ，Koh DM ，Tunariu N ... -  《-》

Whole body MRI (WB-MRI) assessment of metastatic spread in prostate cancer: Therapeutic perspectives on targeted management of oligometastatic disease.

To determine the proportion of prostate cancer (PCa) patients with oligometastatic disease (≤3 synchronous lesions) using whole body magnetic resonance imaging with diffusion-weighted imaging (WB-MRI/DWI). To determine the proportion of patients with nodal disease confined within currently accepted target areas for extended lymph node dissection (eLND) and pelvic external beam radiation therapy (EBRT). Two radiologists reviewed WB-MRI/DWI studies in 96 consecutive newly diagnosed metastatic PCa patients; 46 patients with newly diagnosed castration naive PCa (mHNPC) and 50 patients with first appearance of metastasis during monitoring for non-metastatic castration resistant PCa (M0 to mCRPC). The distribution of metastatic deposits was assessed and the proportions of patients with oligometastatic disease and with LN metastases located within eLND and EBRT targets were determined. Twenty-eight percent of mHNPC and 50% of mCPRC entered the metastatic disease with ≤3 sites. Bone metastases (BM) were identified in 68.8% patients; 71.7% of mHNPC and 66% mCRPC patients. Most commonly involved areas were iliac bones and lumbar spine. Enlarged lymph nodes (LN) were detected in 68.7% of patients; 69.6% of mHNPC and 68.0% of mCRPC. Most commonly involved areas were para-aortic, inter-aortico-cava, and external iliac areas. BM and LN were detected concomitantly in 41% of mHNPC and 34% of mCRPC. Visceral metastases were detected in 6.7%. Metastatic disease was confined to LN located within the accepted boundaries of eLND or pelvic EBRT target areas in only ≤25% and ≤30% of patients, respectively. Non-invasive mapping of metastatic landing sites in PCa using WB-MRI/DWI shows that 28% of the mHNPC patients, and 52% of the mCRPC can be classified as oligometastatic, thus challenging the concept of metastatic targeted therapy. More than two thirds of metastatic patients have LN located outside the usually recommended targets of eLND and pelvic EBRT. Prophylactic or salvage treatments of these sole areas in patients with high-risk prostate cancer may not prevent the emergence of subsequent metastases. Prostate 76:1024-1033, 2016. © 2016 Wiley Periodicals, Inc.

Larbi A ，Dallaudière B ，Pasoglou V ，Padhani A ，Michoux N ，Vande Berg BC ，Tombal B ，Lecouvet FE ... -  《-》

Comparison of (18)F-sodium fluoride PET/CT, (18)F-fluorocholine PET/CT and diffusion-weighted MRI for the detection of bone metastases in recurrent prostate cancer: a cost-effectiveness analysis in France.

Gauthé M ，Zarca K ，Aveline C ，Lecouvet F ，Balogova S ，Cussenot O ，Talbot JN ，Durand-Zaleski I ... -  《BMC MEDICAL IMAGING》