The value of perfusion CT in evaluating locoregional staging in post-radical prostatectomy patients with elevated serum PSA level

Background: The aim of the study was to evaluate the efficiency of perfusion CT (p-CT) in assessing cancer foci in the prostate gland in patients with elevated PSA level who had radical prostatectomy after the p-CT exam. Material/Methods: Prostate p-CT was performed at the Oncology Institute, Cracow, in 2006 in 24 patients aged 49-72 years. The examination was followed by core needle biopsy of the prostate (6-12 cores). PSA levels in the blood ranged from 5.15 to 33.1 ng/ml. The Gleason score estimated after radical prostatectomy ranged from 5 to 8. The parameters BF, BV, PS, and MTT for both prostate lobes at three levels (base, mid-gland, and apex) were measured. Relationships between the presence of pathological foci found in p-CT, serum PSA level, and histopathological findings in the removed prostate gland were analyzed. Results/Conclusions: On the basis of the analyzed material, positive correlation was found between serum PSA level and Gleason score in the post-radical prostatectomy patients. Positive correlation was also found between serum PSA and the presence of pathological lesions detected in p-CT. The higher the level of serum PSA, the higher the probability of detecting a pathological lesion within the prostate gland. No significant correlation between histopathological and p-CT outcome concordance and serum PSA level was noted. However, no correlation between Gleason score and p-CT examination results was found, which suggests that there is no relationship between Gleason score and presence of pathological foci detected in p-CT examination.