Imaging Assessment of Prostate Cancer Extra-prostatic Extension: From Histology to Controversies.

Prostate cancer (PCa) is the most common non-skin malignancy among men and the fourth leading cause of cancer-related deaths globally. Accurate staging of PCa, particularly the assessment of extra-prostatic extension (EPE), is critical for prognosis and treatment planning. EPE, typically evaluated using magnetic resonance imaging (MRI), is associated with higher risks of positive surgical margins, biochemical recurrence, metastasis, and reduced overall survival.

The incremental value of histogram analysis in the differentiation between hyperdense cysts and solid renal masses on unenhanced CT images.

Objective: To investigate the utility of voxel histogram analysis (HA) for differentiating hyperdense renal cysts from small solid masses on unenhanced CT scans.

Methods: A retrospective analysis of 99 hyperdense cystic lesions and 28 solid malignant lesions was conducted using a radiological database (from 2015 to 2021) and a pathological database (from 2010 to 2020). The study investigated the distribution of voxel attenuation values using percentiles to establish reliable criteria for differentiation after drawing a region of interest (ROI) in the centre of the lesions.