title: Correlation between CT perfusion and clinico-pathological features in prostate cancer: a prospective study.
abstract: BACKGROUND
  The aim of the study was to assess the correlation between computed tomography perfusion (PCT) parameters and PSA levels, Gleason score, and pTNM stage in patients with prostate cancer (PCa).
  
  
  METHODS
  One hundred twenty-five patients with localized PCa were prospectively enrolled in the study. All patients were diagnosed due to suspicious prostate findings and elevated PSA serum levels and underwent PCT followed by core biopsy and radical prostatectomy. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability-surface (PS) area product were computed in the suspected PCa area and normal prostatic tissue. Core biopsy followed by prostatectomy was performed 2-4 weeks after PCT. Correlation between PCT findings and PSA levels, Gleason score, and pTNM stage were analyzed.
  
  
  RESULTS
  The mean age of patients was 64 years. All patients had elevated PSA levels (mean value 6.2 ng/ml). Nineteen patients (15.9%) were at low risk of recurrence, 91 (76.5%) were at moderate risk, and 9 (7.6%) were at high risk according to National Comprehensive Cancer Network criteria. PCa was visible on PCT as focal peripheral CT enhancement in 119 out of 125 patients (sensitivity 95.2%). Significant correlations between BV, BF, and PS values and PSA level were found (p<0.05), as well as a trend for difference between BV, BF, and PS in poorly and moderately differentiated tumors (according to Gleason score) in comparison with highly differentiated PCa (p<0.08). The analysis also revealed a correlation between mean perfusion values and BV, MTT, PS, and pTNM cancer stage (p<0.04).
  
  
  CONCLUSIONS
  Our study suggests that in low- and intermediate- risk patients, PCT parameters correlate with PSA values, Gleason score, and pTNM stage and can be useful for initial tumor staging.
authors.affiliation: Department of Radiology, Center of Oncology, M. Skłodowska-Curie Memorial Institute, Cracow, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Łuczyńska
authors.affiliation: Department of Radiology, Center of Oncology, M. Skłodowska-Curie Memorial Institute, Cracow, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Heinze-Paluchowska
authors.affiliation: Department of Gynecologic Oncology, Center of Oncology, M. Skłodowska-Curie Memorial Institute, Cracow, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Blecharz
authors.affiliation: Department of Radioteraphy, European Institute of Oncology, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Jereczek-Fossa
authors.affiliation: Department of Radiology, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Petralia
authors.affiliation: Department of Radiology, European Institute of Oncology, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
authors.affiliation: Department of Surgery, Center of Oncology, M. Skłodowska-Curie Memorial Institute, Cracow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Stelmach
mesh_terms: D000368:Aged; D001706:Biopsy; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods*; D010477:Perfusion; D010539:Permeability; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D017430:Prostate-Specific Antigen