Effects of Prostatic Artery Embolization on the Dynamic Component of Benign Prostate Hyperplasia as Assessed by Ultrasound Elastography: A Pilot Series

  • André Moreira de AssisEmail author
  • Airton Mota Moreira
  • Francisco Cesar Carnevale
  • Antonio Sergio Zafred Marcelino
  • Luciana Mendes de Oliveira Cerri
  • Alberto Azoubel Antunes
  • Miguel Srougi
  • Giovanni Guido Cerri
Clinical Investigation Imaging
Part of the following topical collections:
  1. Imaging



To determine the effects of prostatic artery embolization (PAE) on prostatic elasticity as assessed by Ultrasound Elastography (US-E), as well as to describe the feasibility and role of US-E as a novel tool in both pre- and post-PAE evaluation.

Materials and Methods

This is a prospective, single-center investigation that included eight patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline and 3-month follow-up evaluations were performed and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. US-E with measurement of the prostatic Elastic Modulus (EM) was performed before PAE and at 1-month follow-up.


After PAE, US-E showed a significant reduction of prostatic EM as assessed in kPa (33.14 vs. 47.24, − 29.8%, p = 0.002) and in m/s (3.75 vs. 4.63, − 19.0%, p < 0.001). Also, the transitional/peripheral zone ratio was significantly reduced by 45.36% (0.53 vs. 0.97, p < 0.05). All eight patients presented with significant LUTS improvement after PAE (p < 0.05 for IPSS, QoL, prostate volume, peak urinary flow rate and PSA).


Findings described in this study suggest that PAE significantly reduces prostatic EM, leading to a positive effect on BPH dynamic component related to prostatic elasticity. Also, it features US-E as an additional tool for pre- and post-PAE evaluation, describing a novel indication for this technology.


Benign prostatic hyperplasia Prostate artery embolization Lower urinary tract symptoms Ultrasound Elastography 



This study was not supported by any funding.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The institutional review board approved the study protocol.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • André Moreira de Assis
    • 1
    • 2
    Email author
  • Airton Mota Moreira
    • 1
    • 2
  • Francisco Cesar Carnevale
    • 1
    • 2
  • Antonio Sergio Zafred Marcelino
    • 3
  • Luciana Mendes de Oliveira Cerri
    • 3
  • Alberto Azoubel Antunes
    • 4
  • Miguel Srougi
    • 4
  • Giovanni Guido Cerri
    • 3
    • 5
  1. 1.Interventional Radiology Department, Radiology InstituteUniversity of Sao Paulo Medical SchoolSão PauloBrazil
  2. 2.Interventional Radiology DepartmentSírio-Libanês HospitalSão PauloBrazil
  3. 3.Radiology DepartmentSírio-Libanês HospitalSão PauloBrazil
  4. 4.Urology DepartmentUniversity of Sao Paulo Medical SchoolSão PauloBrazil
  5. 5.Radiology InstituteUniversity of Sao Paulo Medical SchoolSão PauloBrazil

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