CT may help detect peripheral prostate cancer
Screening for prostate adenocarcinoma in healthy men remains a controversial subject. To date, clinicians rely on digital rectal exams or a prostate-specific antigen test to identify early stage cancer. But a new study, published in the American Journal of Roentgenology, suggests that there may be diagnostic value in using CT scanning to detect cancer in the peripheral zone of the prostate.
Researchers from St. Michael’s Hospital’s Department of Medical Imaging in Toronto wanted to identify the sensitivity of contrast-enhanced CT in detecting prostate cancer. The study authors undertook a retrospective analysis of 100 patients with biopsy-proven prostate cancer who underwent a staged contrast-enhanced CT of the abdomen and pelvis within 3 months of diagnosis. They compared those scans to 100 randomly selected age-matched male controls with no history of prostate cancer who had also undergone similar CT scanning. They then recruited two blind readers to independently assess the likelihood of prostate adenocarcinoma based solely on the CT scans.
The blind readers correctly identified 83 out of the 100 patients with prostate cancer, as well as 93 of the 100 matched control participants with a sensitivity of 0.83, a specificity of 0.92, a PPV of 0.91, and NPV of 0.84). Interrater agreement was at 0.76.
Based on these results, the study authors concluded that contrast-enhanced CT may allow radiologists to see a focal area of increased enhancement in the periphery of the prostate that has diagnostic value. Clinicians could use such scans to order further work-up, leading to earlier detection of this deadly disease.