MR imaging findings of the prostate gland following prostate artery embolization

results from a prospective phase 2 study

Rehan Ali, Ahmed Gabr, Samdeep K Mouli, Joseph Ralph Kallini, Ahsun Riaz, Ronald Mora, Robert J Lewandowski, Elias Hohlastos, David Casalino, Matthias Dominikus Hofer, Nabeel Hamoui, Frank H Miller, John Hairston, Riad Salem*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To assess changes in imaging and volume characteristics of the prostate gland by magnetic resonance (MR) following prostatic artery embolization (PAE) for benign prostate hyperplasia. Methods: With IRB approval, we analyzed prospectively acquired MR data of PAE patients at baseline and 6-month following treatment from 2015 to 2017. We reviewed prostate MRs looking for sequelae of embolization [changes in signal intensity and/or enhancement, infection/inflammation, infarction, edema, and change in intravesical prostatic protrusion (IPP)]. We calculated the total volume (TV) and central gland volumes (CGV) using DynaCAD ® and measured change in volumes. Analyses were performed using SPSS with p < 0.05 considered significant. Results: Forty-three patients (n = 43) met our inclusion criteria. 93% (30/43) and 100% (43/43) showed a decrease in TV and CGV at 6-months respectively. At baseline, median TV was 86 cc (range 29.4–232) and median CGV was 54.4 cc (range 12.9–165.5). Median decrease in TV was 18.2% (CI 13.3–27.2) (p = 0.0001) and median decrease in CGV was 26.7% (CI 20.4–35.9) (p = 0.0001). Thirty-seven percent (16/43) of patients had IPP at baseline; 100% showed a decrease in size of median lobe at follow-up. At 6-month follow-up, 33% (14/43) showed imaging features of infarction, 79% (34/43) had decrease in T2-signal intensity, and 51% (22/43) showed a decrease in enhancement. None had edema, peri-prostatic fat changes or infection/inflammation. Conclusion: PAE causes a statistically significant reduction in the TV and CGV. There is also a reduction of the degree of IPP. Non-specific findings of infarction, decrease in T2-signal, and enhancement were also seen.

Original languageEnglish (US)
Pages (from-to)713-722
Number of pages10
JournalAbdominal Radiology
Volume44
Issue number2
DOIs
StatePublished - Feb 15 2019

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Infarction
Prostate
Arteries
Magnetic Resonance Imaging
Edema
Magnetic Resonance Spectroscopy
Inflammation
Research Ethics Committees
Infection
Hyperplasia
Fats
Therapeutics

Keywords

  • MRI prostate
  • Prospective data
  • Prostate artery embolization
  • Volumetric assessment

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

@article{1f399175c3344dc9b5fb7216dd89d495,
title = "MR imaging findings of the prostate gland following prostate artery embolization: results from a prospective phase 2 study",
abstract = "Purpose: To assess changes in imaging and volume characteristics of the prostate gland by magnetic resonance (MR) following prostatic artery embolization (PAE) for benign prostate hyperplasia. Methods: With IRB approval, we analyzed prospectively acquired MR data of PAE patients at baseline and 6-month following treatment from 2015 to 2017. We reviewed prostate MRs looking for sequelae of embolization [changes in signal intensity and/or enhancement, infection/inflammation, infarction, edema, and change in intravesical prostatic protrusion (IPP)]. We calculated the total volume (TV) and central gland volumes (CGV) using DynaCAD {\circledR} and measured change in volumes. Analyses were performed using SPSS with p < 0.05 considered significant. Results: Forty-three patients (n = 43) met our inclusion criteria. 93{\%} (30/43) and 100{\%} (43/43) showed a decrease in TV and CGV at 6-months respectively. At baseline, median TV was 86 cc (range 29.4–232) and median CGV was 54.4 cc (range 12.9–165.5). Median decrease in TV was 18.2{\%} (CI 13.3–27.2) (p = 0.0001) and median decrease in CGV was 26.7{\%} (CI 20.4–35.9) (p = 0.0001). Thirty-seven percent (16/43) of patients had IPP at baseline; 100{\%} showed a decrease in size of median lobe at follow-up. At 6-month follow-up, 33{\%} (14/43) showed imaging features of infarction, 79{\%} (34/43) had decrease in T2-signal intensity, and 51{\%} (22/43) showed a decrease in enhancement. None had edema, peri-prostatic fat changes or infection/inflammation. Conclusion: PAE causes a statistically significant reduction in the TV and CGV. There is also a reduction of the degree of IPP. Non-specific findings of infarction, decrease in T2-signal, and enhancement were also seen.",
keywords = "MRI prostate, Prospective data, Prostate artery embolization, Volumetric assessment",
author = "Rehan Ali and Ahmed Gabr and Mouli, {Samdeep K} and Kallini, {Joseph Ralph} and Ahsun Riaz and Ronald Mora and Lewandowski, {Robert J} and Elias Hohlastos and David Casalino and Hofer, {Matthias Dominikus} and Nabeel Hamoui and Miller, {Frank H} and John Hairston and Riad Salem",
year = "2019",
month = "2",
day = "15",
doi = "10.1007/s00261-018-1757-z",
language = "English (US)",
volume = "44",
pages = "713--722",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",
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}

MR imaging findings of the prostate gland following prostate artery embolization : results from a prospective phase 2 study. / Ali, Rehan; Gabr, Ahmed; Mouli, Samdeep K; Kallini, Joseph Ralph; Riaz, Ahsun; Mora, Ronald; Lewandowski, Robert J; Hohlastos, Elias; Casalino, David; Hofer, Matthias Dominikus; Hamoui, Nabeel; Miller, Frank H; Hairston, John; Salem, Riad.

In: Abdominal Radiology, Vol. 44, No. 2, 15.02.2019, p. 713-722.

Research output: Contribution to journalArticle

TY - JOUR

T1 - MR imaging findings of the prostate gland following prostate artery embolization

T2 - results from a prospective phase 2 study

AU - Ali, Rehan

AU - Gabr, Ahmed

AU - Mouli, Samdeep K

AU - Kallini, Joseph Ralph

AU - Riaz, Ahsun

AU - Mora, Ronald

AU - Lewandowski, Robert J

AU - Hohlastos, Elias

AU - Casalino, David

AU - Hofer, Matthias Dominikus

AU - Hamoui, Nabeel

AU - Miller, Frank H

AU - Hairston, John

AU - Salem, Riad

PY - 2019/2/15

Y1 - 2019/2/15

N2 - Purpose: To assess changes in imaging and volume characteristics of the prostate gland by magnetic resonance (MR) following prostatic artery embolization (PAE) for benign prostate hyperplasia. Methods: With IRB approval, we analyzed prospectively acquired MR data of PAE patients at baseline and 6-month following treatment from 2015 to 2017. We reviewed prostate MRs looking for sequelae of embolization [changes in signal intensity and/or enhancement, infection/inflammation, infarction, edema, and change in intravesical prostatic protrusion (IPP)]. We calculated the total volume (TV) and central gland volumes (CGV) using DynaCAD ® and measured change in volumes. Analyses were performed using SPSS with p < 0.05 considered significant. Results: Forty-three patients (n = 43) met our inclusion criteria. 93% (30/43) and 100% (43/43) showed a decrease in TV and CGV at 6-months respectively. At baseline, median TV was 86 cc (range 29.4–232) and median CGV was 54.4 cc (range 12.9–165.5). Median decrease in TV was 18.2% (CI 13.3–27.2) (p = 0.0001) and median decrease in CGV was 26.7% (CI 20.4–35.9) (p = 0.0001). Thirty-seven percent (16/43) of patients had IPP at baseline; 100% showed a decrease in size of median lobe at follow-up. At 6-month follow-up, 33% (14/43) showed imaging features of infarction, 79% (34/43) had decrease in T2-signal intensity, and 51% (22/43) showed a decrease in enhancement. None had edema, peri-prostatic fat changes or infection/inflammation. Conclusion: PAE causes a statistically significant reduction in the TV and CGV. There is also a reduction of the degree of IPP. Non-specific findings of infarction, decrease in T2-signal, and enhancement were also seen.

AB - Purpose: To assess changes in imaging and volume characteristics of the prostate gland by magnetic resonance (MR) following prostatic artery embolization (PAE) for benign prostate hyperplasia. Methods: With IRB approval, we analyzed prospectively acquired MR data of PAE patients at baseline and 6-month following treatment from 2015 to 2017. We reviewed prostate MRs looking for sequelae of embolization [changes in signal intensity and/or enhancement, infection/inflammation, infarction, edema, and change in intravesical prostatic protrusion (IPP)]. We calculated the total volume (TV) and central gland volumes (CGV) using DynaCAD ® and measured change in volumes. Analyses were performed using SPSS with p < 0.05 considered significant. Results: Forty-three patients (n = 43) met our inclusion criteria. 93% (30/43) and 100% (43/43) showed a decrease in TV and CGV at 6-months respectively. At baseline, median TV was 86 cc (range 29.4–232) and median CGV was 54.4 cc (range 12.9–165.5). Median decrease in TV was 18.2% (CI 13.3–27.2) (p = 0.0001) and median decrease in CGV was 26.7% (CI 20.4–35.9) (p = 0.0001). Thirty-seven percent (16/43) of patients had IPP at baseline; 100% showed a decrease in size of median lobe at follow-up. At 6-month follow-up, 33% (14/43) showed imaging features of infarction, 79% (34/43) had decrease in T2-signal intensity, and 51% (22/43) showed a decrease in enhancement. None had edema, peri-prostatic fat changes or infection/inflammation. Conclusion: PAE causes a statistically significant reduction in the TV and CGV. There is also a reduction of the degree of IPP. Non-specific findings of infarction, decrease in T2-signal, and enhancement were also seen.

KW - MRI prostate

KW - Prospective data

KW - Prostate artery embolization

KW - Volumetric assessment

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U2 - 10.1007/s00261-018-1757-z

DO - 10.1007/s00261-018-1757-z

M3 - Article

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SP - 713

EP - 722

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

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ER -