Spectral CT Imaging In Differential Diagnosis Of The Posterior Wall Bladder Cancer And Prostate Hyperplasia Into The Bladder

Objective: To investigate whether the spectral CT imaging can assist in thedifferential diagnosis of the posterior wall bladder cancer from prostate hyperplasia intothe bladder.Methods: This prospective study was Institutional Review Board approved, andwritten informed consent was obtained from all patients.41patients (20posterior wallbladder cancer and21prostate hyperplasia into the bladder) underwent spectral CTimaging (Discovery CT750HD, GE Healthcare, Mliwaukee, USA) and were provedthrough operation.11different virtual monochromatic images (40-140kev, interval of10keV) were reconstructed using Dual Energy data. At each keV level, regions ofinterest (ROI) were random selected on prostate, prostate hyperplasia into the bladderand posterior wall bladder cancer, respectively.The mean CT value of ROI wasmeasured and the slope (k)of spectral curve was computed. The difference of measuredparameters was evaluated statistically by independent samples t test．Results: For different keV level, posterior wall bladder cancer and correspondingprostate tissue have different CT value. And the mean CT value of the two groups hasstatistically significant difference except for50-70keV. The largest difference of CTvalue of the two groups was found on100keV images (25.88±5.77HU vs38.39±3.11HU; t=-5.776, p=0.002). However, there was no statistically differentbetween the group of prostate and group of prostate hyperplasia into the bladder.According to variable keV, prostate and prostate hyperplasia into the bladder showedthe similar X-ray attenuation coefficient (k=0.25), and posterior wall bladder cancerpossessed a different X-ray spectral curve (k=0.86).Conclusion: The posterior wall bladder cancer and prostate hyperplasia into thebladder had different characteristic on spectral CT imaging. And spectral CT imaging with multiple parameters can distinguish these two types of disease with a higheraccuracy compared to the conventional CT imaging.