Luczynska Elzbieta, Blecharz Pawel, Dyczek Sonia, Stelmach Andrzej, Petralia Giuseppe, Bellomi Massimo, Jereczek-Fossa Barbara Alicja, Jakubowicz Jerzy
Radiology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.
Gynecologic Oncology Department, Centre of Oncology, M Sklodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland.
Ecancermedicalscience. 2014 Oct 27;8:476. doi: 10.3332/ecancer.2014.476. eCollection 2014.
The aim of this study is to assess the usefulness of perfusion computer tomography (pCT) in prostate cancer (PCa) diagnostics.
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.
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).
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.
本研究旨在评估灌注计算机断层扫描（pCT）在前列腺癌（PCa）诊断中的实用性。
94例经活检证实为PCa的患者纳入本研究。静脉注射造影剂后对前列腺进行50秒的动态pCT检查。计算可疑PCa区域和正常前列腺组织的血流（BF）、血容量（BV）、平均通过时间（MTT）和通透性表面积乘积（PS）。
94例受检患者中，90例在pCT上可见PCa，表现为局灶性周边CT强化。当PCa位于外周带（PZ）时，在灌注图上可见，大多表现为早期峰值随后洗脱。肿瘤的所有灌注参数平均值均高于正常前列腺组织（p < 0.000）。BV和BF取决于Gleason评分（GS）所表示的肿瘤分级。所有PCa病例根据组织学分级分为低（GS≤6）、中（GS = 7）和高（GS>7）组。在高级别PCa中，平均BF值显著高于低级别和中级别的PCa（p = 0.001）（低级别和中级别的PCa之间p = 0.011）。关于BV平均值也获得了类似结果；癌症分级越侵袭性，平均BV值越高（p = 0.04）。
CT定量灌注成像可将PCa与正常前列腺组织区分开来。在侵袭性最强的PCa分级中观察到BF和BV的最高值。
