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

  • Clinical Investigation
  • Imaging
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

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.

Results

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).

Conclusions

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.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Interventional Radiology Department, 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, Airton Mota Moreira & Francisco Cesar Carnevale

  2. Interventional Radiology Department, Sírio-Libanês Hospital, Adma Jafet Street, 115 Bela Vista, São Paulo, SP, 01308-050, Brazil

    André Moreira de Assis, Airton Mota Moreira & Francisco Cesar Carnevale

  3. Radiology Department, Sírio-Libanês Hospital, Adma Jafet Street, 115, Bela Vista, São Paulo, SP, 01308-050, Brazil

    Antonio Sergio Zafred Marcelino, Luciana Mendes de Oliveira Cerri & Giovanni Guido Cerri

  4. 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

  5. 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. Airton Mota Moreira
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  3. Francisco Cesar Carnevale
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  4. Antonio Sergio Zafred Marcelino
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  5. Luciana Mendes de Oliveira Cerri
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  6. Alberto Azoubel Antunes
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  7. Miguel Srougi
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  8. Giovanni Guido Cerri
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Corresponding author

Correspondence to André Moreira de Assis.

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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.

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de Assis, A.M., Moreira, A.M., Carnevale, F.C. et al. Effects of Prostatic Artery Embolization on the Dynamic Component of Benign Prostate Hyperplasia as Assessed by Ultrasound Elastography: A Pilot Series. Cardiovasc Intervent Radiol 42, 1001–1007 (2019). https://doi.org/10.1007/s00270-019-02220-x

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  • DOI: https://doi.org/10.1007/s00270-019-02220-x

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