Androgen deprivation therapy

Androgen deprivation therapy (ADT), also called androgen suppression therapy or is a form of treatment in prostate cancer, which basically aims to slow prostate cancer growth by blocking the effect of androgens e.g. testosterone.

Such therapy is mainly used for treating men with intermediate- and high-risk localized prostate cancer in combination with radiotherapy ^1,2.

Androgen deprivation can be achieved by bilateral orchiectomy or medical treatment with luteinizing hormone-releasing hormone agonists or antagonists, antiandrogens and adrenal androgen inhibitors ¹.

Radiographic features

Androgen deprivation therapy will lead to a shrinkage of prostate volume on imaging ^3-7.

MRI

Beyond the prostatic volume decrease it has the following effects on an MRI of the prostate ^3-7:

Signal characteristics

• T2: loss of T2 signal ^3,5
• DWI/ADC ^5,7:
  • increase of ADC values in prostate cancer
  • decrease of ADC values of benign prostatic tissue
• DCE (Gd): reduced dynamic enhancement of prostate cancer ^4,6

Nuclear medicine

PET-CT

On PSMA PET-CT androgen deprivation therapy leads to reduced visibility of hormone-sensitive prostate cancer ⁸.