We sought to investigate whether quantitative parameters from a dynamic contrast-enhanced study can be used to differentiate cancer from normal tissue and to determine a cut-off value of specific parameters that can predict malignancy more accurately, compared to the obturator internus muscle as a reference tissue. This retrospective study included 56 patients with biopsy proven prostate cancer (PCa) after multiparametric magnetic resonance imaging (mpMRI), with a total of 70 lesions; 39 were located in the peripheral zone, and 31 in the transition zone. The quantitative parameters for all patients were calculated in the detected lesion, morphologically normal prostate tissue and the obturator internus muscle. Increase in the Ktrans value was determined in lesion-to-muscle ratio by 3.974368, which is a cut-off value to differentiate between prostate cancer and normal prostate tissue, with specificity of 72.86% and sensitivity of 91.43%. We introduced a model to detect prostate cancer that combines Ktrans lesion-to-muscle ratio value and iAUC lesion-to-muscle ratio value, which is of higher accuracy compared to individual variables. Based on this model, we identified the optimal cut-off value with 100% sensitivity and 64.28% specificity. The use of quantitative DCE pharmacokinetic parameters compared to the obturator internus muscle as reference tissue leads to higher diagnostic accuracy for prostate cancer detection.

Introduction: Leriche's syndrome, as a relatively rare aortoiliac occlusive disease, presents big challenge in every day practice because precise prevalence and incidence are still unknown. Identifying peripheral arterial disease (PAD) presents a challenge, as in 10% of patients, it may be asymptomatic and unrecognized. It is known that the prevalence of PAD increases in aging populations, and nowadays there are many diagnostic tests which are conducted in a number of different settings by health care professionals with varying experience of using assessment tools. There is lack of awareness of this rare condition in general practitioner (GP), and we report this case in order to highlight the importance of complex thinking of pain and claudication in family medicine practice in patients with comorbidity.