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Prostate Zonal Volumetry as a Predictor of Clinical Outcomes for Prostate Artery Embolization

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Abstract

Purpose

To determine prostate baseline zonal volumetry and correlate these findings with clinical outcomes for patients who underwent prostate artery embolization (PAE) for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).

Materials and Methods

This is a retrospective study that included patients treated by PAE from 2010 to 2014. Baseline and 6-month follow-up evaluations included prostate MRI with whole prostate (WP) and central gland (CG) volume measurements—as well as prostate zonal volumetry index (ZVi) calculation, defined as the CG/WP volumes relation—the International Prostate Symptom Score (IPSS), and the Quality of life (QoL) index. Baseline WP, CG, and ZVi were statistical compared to IPSS and QoL values at 6 months.

Results

A total of 93 consecutive patients were included, with mean age of 63.4 years (range, 51–86). Clinical failure, defined as IPSS > 7 or QoL > 2, was seen in four cases (4.3%). Mean reductions in prostate volumes after PAE were of 30.6% and 31.2% for WP and CG, respectively (p < 0.0001). Clinical parameters had mean decrease from 21 to 3.3 points for IPSS, and from 4.7 to 1.2 points for QoL (p < 0.0001). Baseline WP, CG, and ZVi correlated to the degree of clinical improvement (p < 0.05 for all). The baseline ZVi cut-off calculated for better clinical outcomes was > 0.45, with 85% sensitivity and 75% specificity.

Conclusions

Baseline CG and WP volumes as well as ZVi presented strong correlation with clinical outcomes in patients undergoing PAE, and its assessment should be considered in pre-treatment evaluation whenever possible. Both patients and medical team should be aware of the possibility of less favorable outcomes when ZVi < 0.45.

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Authors and Affiliations

  1. Vascular and Interventional Radiology Unit, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil

    André Moreira de Assis, Macello Sampaio Maciel, Airton Mota Moreira, Vanessa Cristina de Paula Rodrigues & Francisco Cesar Carnevale

  2. Urology Department, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil

    Alberto Azoubel Antunes & Miguel Srougi

  3. Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil

    Giovanni Guido Cerri

Authors
  1. André Moreira de Assis
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  2. Macello Sampaio Maciel
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  3. Airton Mota Moreira
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  4. Vanessa Cristina de Paula Rodrigues
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  5. Alberto Azoubel Antunes
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  6. Miguel Srougi
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  7. Giovanni Guido Cerri
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  8. Francisco Cesar Carnevale
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Corresponding author

Correspondence to André Moreira de Assis.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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de Assis, A.M., Maciel, M.S., Moreira, A.M. et al. Prostate Zonal Volumetry as a Predictor of Clinical Outcomes for Prostate Artery Embolization. Cardiovasc Intervent Radiol 40, 245–251 (2017). https://doi.org/10.1007/s00270-016-1518-8

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  • DOI: https://doi.org/10.1007/s00270-016-1518-8

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