Skip to main content
SpringerLink
Log in

Feasibility study of CT perfusion imaging for prostate carcinoma

  • Urogenital
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

The aim of this feasibility study was to obtain initial data with which to assess the efficiency of perfusion CT imaging (CTpI) and to compare this with magnetic resonance imaging (MRI) in the diagnosis of prostate carcinoma.

Materials and methods

This prospective study involved 25 patients with prostate carcinoma undergoing MRI and CTpI. All analyses were performed on T2-weighted images (T2WI), apparent diffusion coefficient (ADC) maps, diffusion-weighted images (DWI) and CTp images. We compared the performance of T2WI combined with DWI and CTp alone. The study was approved by the local ethics committee, and written informed consent was obtained from all patients.

Results

Tumours were present in 87 areas according to the histopathological results. The diagnostic performance of the T2WI+DWI+CTpI combination was significantly better than that of T2WI alone for prostate carcinoma (P < 0.001). The diagnostic value of CTpI was similar to that of T2WI+DWI in combination. There were statistically significant differences in the blood flow and permeability surface values between prostate carcinoma and background prostate on CTp images.

Conclusion

CTp may be a valuable tool for detecting prostate carcinoma and may be preferred in cases where MRI is contraindicated. If this technique is combined with T2WI and DWI, its diagnostic value is enhanced.

Key Points

• Perfusion CT is a helpful technique for prostate carcinoma diagnosis.

• Colour maps allow easy and rapid visual assessment of the functional changes.

• Colour maps of prostate carcinoma provide information about in vivo tumoral vascularity.

• CTp images may be added into routine radiological examinations.

• CTp provides guidance for histopathological correlation if biopsy is scheduled.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

ADC:

apparent diffusion coefficient

BF:

blood flow

BV:

blood volume

CTp:

computed tomography perfusion

DWI:

diffusion weighted imaging

MVD:

microvessel density

PS:

permeability surface

References

  1. Soylu FN, Eggener S, Oto A (2012) Local staging of prostate cancer with MRI. Diagn Interv Radiol 18:365–373

    PubMed  Google Scholar 

  2. Chen M, Dang HD, Wang JY et al (2008) Prostate cancer detection: comparison of T2-weighted imaging, diffusion-weighted imaging, proton magnetic resonance spectroscopic imaging, and the three techniques combined. Acta Radiol 49:602

    Article  CAS  PubMed  Google Scholar 

  3. Haider MA, van der Kwast TH, Tanguay J et al (2007) Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. Am J Roentgenol 189:323–328

    Article  Google Scholar 

  4. Lim HK, Kim JK, Kim KA, Cho KS (2009) Prostate cancer: apparent diffusion coefficient map with T2-weighted images for detection—a multireader study. Radiology 250:145–151

    Article  PubMed  Google Scholar 

  5. Katahira K, Takahara T, Kwee TC et al (2011) Ultra-high-b-value diffusion-weighted MR imaging for the detection of prostate cancer: evaluation in 201 cases with histopathological correlation. Eur Radiol 21:188–196

    Article  PubMed  Google Scholar 

  6. Tan CH, Wang J, Kundra V (2011) Diffusion weighted imaging in prostate cancer. Eur Radiol 21:593–603

    Article  PubMed  Google Scholar 

  7. Engelbrecht MR, Jager GJ, Laheij RJ et al (2002) Local staging of prostate cancer using magnetic resonance imaging: a meta-analysis. Eur Radiol 12:2294–2302

    Article  PubMed  Google Scholar 

  8. Choy M, Rafii S (2001) Role of angiogenesis in the progression and treatment of prostate cancer. Cancer Invest 19:181–191

    Article  CAS  PubMed  Google Scholar 

  9. Aragon-Ching JB, Dahut WL (2009) VEGF inhibitors and prostate cancer therapy. Curr Mol Pharmacol 2:161–168

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Bunsiripaiboon P, Sornmayura P, Wilasrusmee C, Lertsithichai P (2010) The prognostic significance of microvessel density in intrahepatic cholangiocarcinoma. J Med Assoc Thai 93:66–72

    PubMed  Google Scholar 

  11. Erbersdobler A, Isbarn H, Dix K et al (2010) Prognostic value of microvessel density in prostate cancer: a tissue microarray study. World J Urol 28:687–692

    Article  PubMed  Google Scholar 

  12. Cuenod CA, Fournier L, Balvay D, Guinebretière JM (2006) Tumor angiogenesis: pathophysiology and implications for contrast-enhanced MRI and CT assessment. Abdom Imaging 31:188–193

    Article  CAS  PubMed  Google Scholar 

  13. Hawighorst H, Knapstein PG, Knopp MV et al (1998) Uterine cervical carcinoma: comparison of standard and pharmacokinetic analysis of time-intensity curves for assessment of tumor angiogenesis and patient survival. Cancer Res 58:3598–3602

    CAS  PubMed  Google Scholar 

  14. Miles KA (2006) Perfusion imaging with computed tomography: brain and beyond. Eur Radiol 16:37–43

    Article  Google Scholar 

  15. Gandhi D, Hoeffner EG, Carlos RC (2003) Computed tomography perfusion of squamous cell carcinoma of the upper aerodigestive tract initial results. J Comput Assist Tomogr 27:687–693

    Article  PubMed  Google Scholar 

  16. Kan Z, Phongkitkarun S, Kobayashi S et al (2005) Functional CT for quantifying tumor perfusion in antiangiogenic therapy in a rat model. Radiology 237:151–158

    Article  PubMed  Google Scholar 

  17. Li Y, Yang ZG, Chen TW et al (2008) Whole tumour perfusion of peripheral lung carcinoma: evaluation with first-pass CT perfusion imaging at 64-detector row CT. Clin Radiol 63:629–635

    Article  CAS  PubMed  Google Scholar 

  18. Sahani DV, Holalkere NS, Mueller PR et al (2007) Advanced hepatocellular carcinoma: CT perfusion of liver and tumor tissue—initial experience. Radiology 243:736–743

    Article  PubMed  Google Scholar 

  19. Sahani DV, Kalva SP, Hamberg LM et al (2005) Assessing tumor perfusion and treatment response in rectal cancer with multisection CT: initial observations. Radiology 234:785–792

    Article  PubMed  Google Scholar 

  20. Miles KA (2002) Functional computed tomography in oncology. Eur J Cancer 38:2079–2084

    Article  CAS  PubMed  Google Scholar 

  21. Miles KA, Griffiths MR (2003) Perfusion CT: a worthwhile enhancement? Br J Radiol 76:220–231

    Article  CAS  PubMed  Google Scholar 

  22. Mullerad M, Hricak H, Kuroiwa K et al (2005) Comparison of endorectal magnetic resonance imaging, guided prostate biopsy and digital rectal examination in the preoperative anatomical localization of prostate cancer. J Urol 174:2158–2163

    Article  PubMed  Google Scholar 

  23. Vargas HA, Akin O, Franiel T et al (2011) Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: tumor detection and assessment of aggressiveness. Radiology 259:775–784

    Article  PubMed Central  PubMed  Google Scholar 

  24. Miao H, Fukatsu H, Ishigaki T (2007) Prostate cancer detection with 3-T MRI: comparison of diffusion-weighted and T2-weighted imaging. Eur J Radiol 61:297–302

    Article  PubMed  Google Scholar 

  25. Osimani M, Bellini D, Di Cristofano C et al (2012) Perfusion MDCT of prostate cancer: correlation of perfusion CT parameters and immunohistochemical markers of angiogenesis. Am J Roentgenol 199:1042–1048

    Article  Google Scholar 

  26. Kerbel RS (2008) Tumor angiogenesis. N Engl J Med 358:2039–2049

    Article  CAS  PubMed  Google Scholar 

  27. Padhani AR, Harvey CJ, Cosgrove DO (2005) Angiogenesis imaging in the management of prostate cancer. Nat Clin Pract Urol 2:596–607

    Article  PubMed  Google Scholar 

  28. Choyke PL, Dwyer AJ, Knopp MV (2003) Functional tumor imaging with dynamic contrast-enhanced magnetic resonance imaging. J Magn Reson Imaging 17:509–520

    PubMed  Google Scholar 

  29. Gossmann A, Helbich TH, Kuriyama N et al (2002) Dynamic contrast-enhanced magnetic resonance imaging as a surrogate marker of tumor response to anti-angiogenic therapy in a xenograft model of glioblastoma multiforme. J Magn Reson Imaging 15:233–240

    PubMed  Google Scholar 

  30. Maxwell RJ, Wilson J, Prise VE et al (2002) Evaluation of the anti-vascular effects of combretastatin in rodent tumours by dynamic contrast enhanced MRI. NMR Biomed 15:89–98

    Article  CAS  PubMed  Google Scholar 

  31. Hara N, Okuizumi M, Koike H et al (2005) Dynamic contrast-enhanced MR imaging (DCE–MRI) is a useful modality for the precise detection and staging of early prostate cancer. Prostate 62:140–147

    Article  PubMed  Google Scholar 

  32. Ocak I, Bernardo M, Metzger G et al (2007) Dynamic contrast-enhanced MRI of prostate cancer at 3T: a study of pharmacokinetic parameters. Am J Roentgenol 189:192–201

    Article  Google Scholar 

  33. Scherr MK, Seitz M, Muller-Lisse UG et al (2010) MR perfusion (MRP) and diffusion-weighted imaging (DWI) in prostate cancer: quantitative and model-based gadobenate dimeglumine MRP parameters in detection of prostate cancer. Eur J Radiol 76:359–366

    Article  CAS  PubMed  Google Scholar 

  34. Ives EP, Burke MA, Edmonds PR et al (2005) Quantitative computed tomography perfusion of prostate cancer: correlation with whole-mount pathology. Clin Prostate Cancer 4:109–112

    PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Mecit Kantarci. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Written informed consent was waived by the institutional review board. Methodology: prospective, diagnostic study, performed at one institution.

Conflict of interest

We have declared that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Muğla Sıtkı Koçman University, School of Medicine, Muğla, Turkey

    Nesat Cullu

  2. Department of Radiology, Atatürk University, School of Medicine, 200 Evler Mah. 14. Sok No 5 Dadaskent, Erzurum, Turkey

    Nesat Cullu, Mecit Kantarci, Hayri Ogul, Aylin Okur, Berhan Pirimoglu, Leyla Karaca & Yesim Kizrak

  3. Department of Urology, Atatürk University, School of Medicine, Erzurum, Turkey

    Senol Adanur, Erdem Koc & Ozkan Polat

  4. Department of Radiology, Bozok University, School of Medicine, Yozgat, Turkey

    Aylin Okur

Authors
  1. Nesat Cullu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mecit Kantarci
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hayri Ogul
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Senol Adanur
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aylin Okur
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Erdem Koc
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Berhan Pirimoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Leyla Karaca
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yesim Kizrak
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ozkan Polat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mecit Kantarci.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cullu, N., Kantarci, M., Ogul, H. et al. Feasibility study of CT perfusion imaging for prostate carcinoma. Eur Radiol 24, 2236–2244 (2014). https://doi.org/10.1007/s00330-014-3212-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-014-3212-z

Keywords

Search

Navigation