Literature DB >> 26738505

Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE.

Yen-Ting Lin1,2, Grégory Amouyal3, Jean-Michel Correas3,4, Héléna Pereira3, Olivier Pellerin3,5,6, Costantino Del Giudice3, Carole Déan3, Nicolas Thiounn7, Marc Sapoval3,5,6.   

Abstract

OBJECTIVES: To assess the impact of prostatic arterial embolisation (PAE) on various prostate gland anatomical zones.
METHODS: We retrospectively reviewed paired MRI scans obtained before and after PAE for 25 patients and evaluated changes in volumes of the median lobe (ML), central gland (CG), peripheral zone (PZ) and whole prostate gland (WPV) following PAE. We used manual segmentation to calculate volume on axial view T2-weighted images for ML, CG and WPV. We calculated PZ volume by subtracting CG volume from WPV. Enhanced phase on dynamic contrasted-enhanced MRI was used to evaluate the infarction areas after PAE. Clinical results of International Prostate Symptom Score and International Index of Erectile Function questionnaires and the urodynamic study were evaluated before and after PAE.
RESULTS: Significant reductions in volume were observed after PAE for ML (26.2 % decrease), CG (18.8 %), PZ (16.4 %) and WPV (19.1 %; p < 0.001 for all these volumes). Patients with clinical failure had smaller volume reductions for WPV, ML and CG (all p < 0.05). Patients with significant CG infarction after PAE displayed larger WPV, ML and CG volume reductions (all p < 0.01).
CONCLUSIONS: PAE can significantly decrease WPV, ML, CG and PZ volumes, and poor clinical outcomes are associated with smaller volume reductions. KEY POINTS: • The MRI segmentation method provides detailed comparisons of prostate volume change. • Prostatic arterial embolisation (PAE) decreased central gland and peripheral zone volumes. • Prostates with infarction after PAE showed larger decreases in volume. • A larger decrease in prostate volume is associated with clinical success.

Entities:  

Keywords:  Anatomy, cross-sectional; Benign prostatic hyperplasia; Magnetic resonance imaging; Prostate; Therapeutic embolisation

Mesh:

Substances:

Year:  2016        PMID: 26738505     DOI: 10.1007/s00330-015-4177-2

Source DB:  PubMed          Journal:  Eur Radiol        ISSN: 0938-7994            Impact factor:   5.315


  26 in total

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5.  Prostatic artery embolization to treat lower urinary tract symptoms related to benign prostatic hyperplasia and bleeding in patients with prostate cancer: proceedings from a multidisciplinary research consensus panel.

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6.  Response to "does polyvinyl alcohol particle size change the outcome of prostatic arterial embolization for benign prostatic hyperplasia? Results from a single-center randomized prospective study".

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9.  Unilateral versus bilateral prostatic arterial embolization for lower urinary tract symptoms in patients with prostate enlargement.

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Journal:  Cardiovasc Intervent Radiol       Date:  2012-12-12       Impact factor: 2.740

10.  Human cadaveric specimen study of the prostatic arterial anatomy: implications for arterial embolization.

Authors:  Ricardo Garcia-Monaco; Lucas Garategui; Nestor Kizilevsky; Oscar Peralta; Pablo Rodriguez; Jose Palacios-Jaraquemada
Journal:  J Vasc Interv Radiol       Date:  2013-12-08       Impact factor: 3.464

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8.  Semi-Automatic MRI Feature Assessment in Small- and Medium-Volume Benign Prostatic Hyperplasia after Prostatic Artery Embolization.

Authors:  Vanessa F Schmidt; Mirjam Schirren; Maurice M Heimer; Philipp M Kazmierczak; Clemens C Cyran; Moritz Wildgruber; Max Seidensticker; Jens Ricke; Olga Solyanik
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