Hippocrates Moschouris1, Konstantinos Stamatiou2, Mariana Kalokairinou Motogna3, Spyros Vrakas4, Michail Kiltenis5, Konstantinos Kladis-Kalentzis6, Avraam Tsavdaroglou7, Nikolaos Papadogeorgopoulos8, Kyriaki Marmaridou9, Katerina Malagari10. 1. Department of Radiology, Tzaneion General Hospital, Piraeus 18536, Greece. hipmosch@gmail.com. 2. Department of Urology, Tzaneion General Hospital, Piraeus 18536, Greece. stamatiouk@gmail.com. 3. Department of Radiology, Thriassion General Hospital, Athens 19018, Greece. motogna@hotmail.com. 4. Department of Gastroenterology, Tzaneion General Hospital, Piraeus 18536, Greece. sbrakas@yahoo.gr. 5. Department of Radiology, Tzaneion General Hospital, Piraeus 18536, Greece. kiltenis@gmail.com. 6. Department of Radiology, Tzaneion General Hospital, Piraeus 18536, Greece. kalentziskonstantinos@gmail.com. 7. Department of Radiology, Tzaneion General Hospital, Piraeus 18536, Greece. avraam1084@gmail.com. 8. Department of Radiology, Tzaneion General Hospital, Piraeus 18536, Greece. npapadogeorgopoulos@gmail.com. 9. Department of Radiology, Tzaneion General Hospital, Piraeus 18536, Greece. kiriaki.marmaridou@gmail.com. 10. Second Department of Radiology, University of Athens, Attikon Hospital, Chaidari, Athens 12462, Greece. kmalag@otenet.gr.
Abstract
AIMS: To assess the feasibility, findings and potential value of early post-interventional, contrast-enhanced ultrasonographic (CEUS) study of prostate artery embolization (PAE). MATERIAL AND METHODS: Fourteen patients treated with PAE for symptomatic benign prostatic hyperplasia were prospectively included in the study. Sonographic evaluation of the prostate included: 1) baseline transabdominal and transrectal CEUS (ta-CEUS and tr-CEUS, respectively) 1-3 days prior to PAE; 2) early post PAE CEUS, with ta-CEUS immediately post PAE and tr-CEUS 3 days post PAE; and 3) follow-up with ta-CEUS and tr-CEUS 3 months post PAE. A brief unenhanced US study preceded each CEUS. Post-therapeutic changes in size, echogenicity and enhancement of the prostate were recorded and were correlated with clinical outcomes. RESULTS: PAE resulted in clinical success in 11/14 patients (78.5%). All sonographic studies were technically adequate, with the exception of ta-CEUS immediately post PAE in 2/14 (14.2%) patients. CEUS studies immediately post PAE and 3 days post PAE showed non-enhancing, welldefined infarctions of the prostate in 10/14 patients (71.4%). There was a strong correlation between ta-CEUS immediately post PAE and tr-CEUS 3 days post PAE regarding the measurements of prostatic infarctions (r =0.98, p< 0.01). The presence of infarctions on early post PAE CEUS was associated with clinical success (p=0.01) and their extent correlated with the degree of prostate shrinkage on 3-month follow-up (r=0.84, p<0.05). The 3 cases of failed PAE showed no infarctions and no prostate shrinkage. CONCLUSIONS: Early post-interventional CEUS of PAE is feasible and may have clinical and prognostic value.
AIMS: To assess the feasibility, findings and potential value of early post-interventional, contrast-enhanced ultrasonographic (CEUS) study of prostate artery embolization (PAE). MATERIAL AND METHODS: Fourteen patients treated with PAE for symptomatic benign prostatic hyperplasia were prospectively included in the study. Sonographic evaluation of the prostate included: 1) baseline transabdominal and transrectal CEUS (ta-CEUS and tr-CEUS, respectively) 1-3 days prior to PAE; 2) early post PAE CEUS, with ta-CEUS immediately post PAE and tr-CEUS 3 days post PAE; and 3) follow-up with ta-CEUS and tr-CEUS 3 months post PAE. A brief unenhanced US study preceded each CEUS. Post-therapeutic changes in size, echogenicity and enhancement of the prostate were recorded and were correlated with clinical outcomes. RESULTS:PAE resulted in clinical success in 11/14 patients (78.5%). All sonographic studies were technically adequate, with the exception of ta-CEUS immediately post PAE in 2/14 (14.2%) patients. CEUS studies immediately post PAE and 3 days post PAE showed non-enhancing, welldefined infarctions of the prostate in 10/14 patients (71.4%). There was a strong correlation between ta-CEUS immediately post PAE and tr-CEUS 3 days post PAE regarding the measurements of prostatic infarctions (r =0.98, p< 0.01). The presence of infarctions on early post PAE CEUS was associated with clinical success (p=0.01) and their extent correlated with the degree of prostate shrinkage on 3-month follow-up (r=0.84, p<0.05). The 3 cases of failed PAE showed no infarctions and no prostate shrinkage. CONCLUSIONS: Early post-interventional CEUS of PAE is feasible and may have clinical and prognostic value.