Mass-like peripheral zone enhancement on CT is predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer

Glazer, Daniel I.; Davenport, Matthew S.; Khalatbari, Shokoufeh; Cohan, Richard H.; Ellis, James H.; Caoili, Elaine M.; Stein, Erica B.; Childress, John C.; Masch, William R.; Brown, Julia; Mollard, Brett J.; Montgomery, Jeffrey S.; Palapattu, Ganesh S.; Francis, Isaac R.

doi:10.1007/s00261-014-0233-7

Cited by 10 publications

(5 citation statements)

References 13 publications

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“…The agreement between readers, as well as general performance, will increase as the training levels increase with this new technique. Similar to Glazer et al [25] and Jia et al [24], we found that DCE-CT enables the detection and differentiation of PCa in the PZ. A veritable advantage of DCE-CT compared to single-phase CT is the ability to generate MIP images and perfusion maps.…”

Section: Discussionsupporting

confidence: 90%

“…In another retrospective study, Glazer et al reevaluated non-dynamic, contrast-enhanced CT of the abdomen and pelvis in 90 patients with PCa and 49 patients without PCa. A visual grading score of 5 increased the likelihood of a higher-grade PCa from 31% to 81% in this study population [25]. These two studies might suggest that, even in single phase pelvic CT, a PCa lesion can be detected.…”

Section: Discussionmentioning

confidence: 81%

“…Second, as we included patients with Gleason scores 6–9, we had a high number of patients with low-Gleason-score tumors. Based on previous reports, in which higher-grade tumors were better visible on pelvic CTs [14,25], it is likely that a higher number of high-grade tumors would have improved the detection rate of CTs. In addition, we did not calculate the false-positive or false-negative rate.…”

Section: Discussionmentioning

confidence: 99%

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4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study

et al. 2019

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PurposeAdvanced forms of prostate cancer (PCa) radiotherapy with either external beam therapy or brachytherapy delivery techniques aim for a focal boost and thus require accurate lesion localization and lesion segmentation for subsequent treatment planning. This study prospectively evaluated dynamic contrast-enhanced computed tomography (DCE-CT) for the detection of prostate cancer lesions in the peripheral zone (PZ) using qualitative and quantitative image analysis compared to multiparametric magnet resonance imaging (mpMRI) of the prostate.MethodsWith local ethics committee approval, 14 patients (mean age, 67 years; range, 57–78 years; PSA, mean 8.1 ng/ml; range, 3.5–26.0) underwent DCE-CT, as well as mpMRI of the prostate, including standard T2, diffusion-weighted imaging (DWI), and DCE-MRI sequences followed by transrectal in-bore MRI-guided prostate biopsy. Maximum intensity projections (MIP) and DCE-CT perfusion parameters (CTP) were compared between healthy and malignant tissue. Two radiologists independently rated image quality and the tumor lesion delineation quality of PCa using a five-point ordinal scale. MIP and CTP were compared using visual grading characteristics (VGC) and receiver operating characteristics (ROC)/area under the curve (AUC) analysis.ResultsThe PCa detection rate ranged between 57 to 79% for the two readers for DCE-CT and was 92% for DCE-MRI. DCE-CT perfusion parameters in PCa tissue in the PZ were significantly different compared to regular prostate tissue and benign lesions. Image quality and lesion visibility were comparable between DCE-CT and DCE-MRI (VGC: AUC 0.612 and 0.651, p>0.05).ConclusionOur preliminary results suggest that it is feasible to use DCE-CT for identification and visualization, and subsequent segmentation for focal radiotherapy approaches to PCa.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study

et al. 2019

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“…Disease-free survival and risk of metastases vary greatly between lower grade (Gleason 3+3 and 3+4) and higher grade (Gleason 4+3 and above) cancer and between Gleason pattern 3+4 and Gleason pattern 4+3 tumors (8–11). Consequently, several authors have proposed modified scoring systems based on a quantitative Gleason grade in which the percentage of each pattern is reported or alternative grading systems such as the Prostate Cancer Prevention Trial Risk Calculator so as to more accurately reflect prognosis and reduce overtreatment (12–14).…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: correlation with tumor cell density and percentage Gleason pattern on whole mount pathology

et al. 2016

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Objective To determine if tumor cell density and percentage of Gleason pattern within an outlined volumetric tumor region of interest (TROI) on whole-mount pathology (WMP) correlate with ADC values on corresponding TROIs outlined on pre-operative MRI. Methods Men with biopsy-proven prostate adenocarcinoma undergoing multiparametric MRI (mpMRI) prior to prostatectomy were consented to this prospective study. WMP and mpMRI images were viewed using 3D Slicer and each TROI from WMP was contoured on the high b-value ADC maps (b0, 1400). For each TROI outlined on WMP, TCD (tumor cell density) and the percentage of Gleason pattern 3, 4, and 5 were recorded. The ADCmean, ADC10th percentile, ADC90th percentile, and ADCratio were also calculated in each case from the ADC maps using 3D Slicer. Results Nineteen patients with 21 tumors were included in this study. ADCmean values for TROIs were 944.8 ± 327.4 mm2/sec vs. 1329.9 ± 201.6 mm2/sec for adjacent non-neoplastic prostate tissue (p<0.001). ADCmean, ADC10th percentile, and ADCratio values for higher grade tumors were lower than those of lower grade tumors (mean: 809.71 and 1176.34 mm2/sec, p=0.014; 10th percentile: 613.83 and 1018.14 mm2/sec, p=0.009; ratio: 0.60 and 0.94, p=0.005). TCD and ADCmean (ρ= −0.61, p=0.005) and TCD and ADC10th percentile (ρ= −0.56, p=0.01) were negatively correlated. No correlation was observed between percentage of Gleason pattern and ADC values. Conclusion DWI MRI can characterize focal prostate cancer using ADCratio, ADC10th percentile, and ADCmean, which correlate with pathological tumor cell density.

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“…Однако впоследствии дан ный метод не вошел в клиническую практику из за широкого распространения МРТ, которая превос ходит КТ в выявлении локализованного РПЖ. Ис следования последних лет, проведенные на совре менных томографах с использованием болюсного контрастирования, подтверждают, что чувствитель ность КТ с контрастированием ниже, чем у МРТ (63 vs. 88 %), однако специфичность КТ выше (98 vs. 86 %) [5,9,13]. С 2005 г. в литературе стали появ ляться работы о возможности использования пер фузионной компьютерной томографии (ПКТ) в диагностике локализованного РПЖ [2,11].…”

Section: Introductionunclassified

Using 320-slice perfusion computed tomography in visuali zation of prostate cancer

Сосновский¹,

Розенгауз²,

Школьник³

et al. 2016

Uč. zap. St.-Peterbg. gos. med. univ. im. Akad. I.P. Pavlova

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Mass-like peripheral zone enhancement on CT is predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer

Abstract: Focal mass-like peripheral zone enhancement on routine venous-phase CT is specific and predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer.

Cited by 10 publications

References 13 publications

4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study

4D perfusion CT of prostate cancer for image-guided radiotherapy planning: A proof of concept study

Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: correlation with tumor cell density and percentage Gleason pattern on whole mount pathology

Using 320-slice perfusion computed tomography in visuali zation of prostate cancer

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