Tumour blood flow for prediction of human prostate cancer aggressiveness: a study with Rubidium-82 PET, MRI and Na+/K+-ATPase-density

Purpose Tumour blood flow (TBF) is a crucial determinant of cancer growth. Recently, we validated Rubidium-82 ( 82 Rb) positron emission tomography (PET) for TBF measurement in prostate cancer (PCa) and found TBF and cancer aggressiveness positively correlated. The aims of the present study were to determine the ability of TBF for separating significant from insignificant PCa and to examine the relation to underlying Na + /K + -ATPase density, which is relevant as 82 Rb is transported intracellularly via the Na + /K + -ATPase. Methods One hundred and two patients were included for pelvic 82 Rb PET scan prior to magnetic resonance imaging (MRI)-guided prostate biopsy. Findings constituted 100 PCa lesions (86 patients) and 25 benign lesions (16 patients). Tumours were defined on MRI and transferred to 82 Rb PET for TBF measurement. Immunohistochemical Na + /K + -ATPase staining was subsequently performed on biopsies. Results TBF was the superior predictor (rho = 0.68, p