Abstract
PurposeThe aim of this study is to assess the usefulness of perfusion computer tomography (pCT) in prostate cancer (PCa) diagnostics.Materials and Methods94 patients with biopsy-proven PCa were enrolled in the study. Dynamic pCT of the prostate gland was performed for 50 seconds after an intravenous injection of contrast medium. Blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) were computed in the suspected PCa area and in normal prostatic tissue.ResultsPCa was visible in pCT in 90 of the 94 examined patients as a focal peripheral CT enhancement. When PCa was located in the peripheral zone (PZ), it was visible on perfusion maps, mostly showing an early peak followed by wash-out. The average values of all perfusion parameters were higher for tumour than for normal prostate tissue (p < 0.000). BV and BF were dependent on tumour grade expressed by the Gleason score (GS). All PCa cases were divided into groups, according to histological grade, as low (GS ≤ 6), medium (GS = 7), and high (GS > 7). In high-grade PCa, the mean BF value was significantly higher (p = 0.001) than the mean value of BF low- and medium-grade PCa (p = 0.011). Similar results were obtained regarding the mean values of BV; the more aggressive the cancer grade, the higher the mean BV value (p = 0.04).ConclusionCT quantitative perfusion imaging allows PCa to be distinguished from normal prostate tissue. The highest values for BF and BV were observed in the most aggressive PCa grade.
Highlights
In terms of frequency and incidence, prostate cancer (PCa) is the second most common malignant tumour in Europe and the United States [1]
When PCa was located in the peripheral zone (PZ), it was visible on perfusion maps, mostly showing an early peak followed by wash-out
Between 2007 and 2011, abdominal and pelvic CT and prostate gland perfusion CT were performed in 127 patients who were eligible for the study protocol and signed informed consent
Summary
In terms of frequency and incidence, prostate cancer (PCa) is the second most common malignant tumour in Europe and the United States [1]. The group of patients with contraindications for MRI like claustrophobia, metallic endoprosthesis, pace-makers (non MRI-compatible), and stents must be considered; MRI devices are not widespread in lower-middle-income countries and prostate MRI interpretation requires experience in functional imaging techniques, such as diffusion-weighted MRI, dynamic contrast-enhanced MRI (DCE-MRI) and magnetic resonance spectroscopy (MRS). They make the PCT as a promising diagnostic tool in the selected groups of patients [7]
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