الفهرس 
Introduction and Aim of workOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
Prostate cancer is a progressive disease with increasing incidence
all over the world.
Prostate image is the most difficult image to interpret; thus the
need for employing new imaging modalities that produce quantitative
results rather than the qualitative image as MDCT perfusion or H+1 MR
Spectroscopy.
CT perfusion is a rather old technique which had revolved again
and became a powerful imaging modality in imaging of angioneogenesiswhich
is an integral part in the pathogenesis of malignant tumors. – The
re-evolution of such technique is attributed to:
The recent developments in the anti-neoangiogensis agents
and their increasing role in treatment of malignant tumours.
The recent technology introduced in the field of radiology in
terms of MDCT with increased both the spatial and temporal
resolution with faster CT scanners.
The reproduction of standard perfusion values for each organ
which enable judgment of the perfusion values i.e. Acting as
a reference value which facilate the judgment of the
perfusion parameters whether they are increased or
decreased.
CT perfusion estimates 4 parameters which are the blood flow,
blood volume, surface permeability and mean transient time. The general
rule for diagnosis of malignant tumors when there is increased values of
the blood flow, blood volume, surface permeability and decreased value
of the mean transient time than the standard perfusion value.
The CT perfusion studies is a quantitative non invasive imaging
modality that allow accurate diagnosis of neoangiogensis and in turn
malignant changes but this does not cancel the need for histopathological
verification, but it may have a strong role in determining site to be
biopsied and in turn decrease the number of random prostatic biopsy core
and further evaluation in the management of prostate cancer whether via
radiotherapy or hormonal treatment.
This study shows that CT perfusion a strong role in the diagnosis
of prostate cancer with sensitivity 90.54%, specificity 86.8%, positive
predictive value 93.056 % and negative predictive value 82.5% , accuracy
89.3% and pre-test probability= 64.3%.
Limitations of the study :
In our own opinion the limitations that faced this thesis were:
No sufficient previous studies.
Beam hardening artifacts from hip prosthesis
Relatively high radiation dose
No cases performed CT perfusion post-radiotherapy.