title: Perfusion CT is a valuable diagnostic method for prostate cancer: a prospective study of 94 patients.
abstract: OBJECTIVE
  The aim of this study is to assess the usefulness of perfusion computer tomography (pCT) in prostate cancer (PCa) diagnostics.
  
  
  METHODS
  94 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.
  
  
  RESULTS
  PCa 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).
  
  
  CONCLUSIONS
  CT 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.
authors.affiliation: Radiology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Luczynska
authors.affiliation: Gynecologic Oncology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Blecharz
authors.affiliation: Radiology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Dyczek
authors.affiliation: Radiotherapy Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Stelmach
authors.affiliation: Radiology Department, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Petralia
authors.affiliation: Radiology Department, European Institute of Oncology, Milan, Italy ; Radiology Department, European Institute of Oncology, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
authors.affiliation: Radiotherapy Department, European Institute of Oncology, Milan, Italy ; University of Milan, Milan, Italy.
authors.forename: Barbara Alicja
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.affiliation: Surgery Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jakubowicz
keywords: angiogenesis; perfusion CT; prostate cancer