"In Physically Active Patients Predisposed to Bone- Muscle Attrition Receiving Androgen Deprivation Therapy for Prostate Cancer Treatment, Prospective MRI Evaluation Does Not Demonstrate Significant Muscle Alteration"

Avneesh Chhabra
2021 Biomedical Journal of Scientific & Technical Research  
Introduction The Global Cancer Observatory identified Prostate Cancer as the 2 nd most commonly diagnosed cancer and 5th most deadly in men worldwide [1] . Androgens are important for the growth of the prostate gland, and men with elevated testosterone levels are shown to have an increased risk for developing prostate cancer [2] . Androgen deprivation therapy (ADT) has been used as a standard of care treatment for prostate cancer amelioration and it has shown to reduce adult prostatic
more » ... cell growth and improve the quality of life in such patients [3, 4] . Although ADT has been useful in the treatment of prostate cancer, it causes many adverse effects such as decreased bone density as confirmed by DEXA (dual energy X-ray absorptiometry) scans and increased fracture risk. Since the muscle-bone unit works in tandem and testosterone ARTICLE INFO ABSTRACT Introduction/Aims: To prospectively determine the effects of Androgen Deprivation Therapy (ADT) on muscle mass and intramuscular proton diffusion on 3-Tesla MRI. We hypothesized that androgen deprivation therapy will cause a significant decrease in muscle mass and increase in apparent diffusion coefficient (ADC). Methods: A consecutive series of 16 physically active patients with proven prostate cancer treated with androgen deprivation therapy were prospectively recruited. MRI was obtained at 3 time points at two sites (gluteal and thigh regions) using a torso XL coil and a combination of 3-dimensional (3D) T2 Dixon and DWI sequences. Two trained readers measured muscle areas on axial reconstructions from 3D imaging and apparent diffusion coefficient of bilateral gluteus medius, iliopsoas and quadriceps muscles at fixed points. Linear mixed model was used to analyze the trends in each measurement along 3 time-intervals. Result: Agreement between the readers was good to excellent for all measurements except area measurements of the bilateral iliopsoas muscles. On further mixed modeling, false discovery rate adjusted p-value did not show significant linear trend across any of the measurements (p>0.05). During at least six-month follow-up period, the patients denied any falls or fractures. Discussion: In physically active men, androgen deprivation therapy in prostate cancer patients does not result in significant morphologic changes in pelvis and thigh muscle area or functional intramuscular diffusion in the short-term.
doi:10.26717/bjstr.2021.37.005981 fatcat:vk7auauqubb5vfwsp6enb5eviu