European Radiology

, Volume 26, Issue 10, pp 3466–3473 | Cite as

Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE

  • Yen-Ting LinEmail author
  • Grégory Amouyal
  • Jean-Michel Correas
  • Héléna Pereira
  • Olivier Pellerin
  • Costantino Del Giudice
  • Carole Déan
  • Nicolas Thiounn
  • Marc Sapoval



To assess the impact of prostatic arterial embolisation (PAE) on various prostate gland anatomical zones.


We retrospectively reviewed paired MRI scans obtained before and after PAE for 25 patients and evaluated changes in volumes of the median lobe (ML), central gland (CG), peripheral zone (PZ) and whole prostate gland (WPV) following PAE. We used manual segmentation to calculate volume on axial view T2-weighted images for ML, CG and WPV. We calculated PZ volume by subtracting CG volume from WPV. Enhanced phase on dynamic contrasted-enhanced MRI was used to evaluate the infarction areas after PAE. Clinical results of International Prostate Symptom Score and International Index of Erectile Function questionnaires and the urodynamic study were evaluated before and after PAE.


Significant reductions in volume were observed after PAE for ML (26.2 % decrease), CG (18.8 %), PZ (16.4 %) and WPV (19.1 %; p < 0.001 for all these volumes). Patients with clinical failure had smaller volume reductions for WPV, ML and CG (all p < 0.05). Patients with significant CG infarction after PAE displayed larger WPV, ML and CG volume reductions (all p < 0.01).


PAE can significantly decrease WPV, ML, CG and PZ volumes, and poor clinical outcomes are associated with smaller volume reductions.

Key Points

• The MRI segmentation method provides detailed comparisons of prostate volume change.

• Prostatic arterial embolisation (PAE) decreased central gland and peripheral zone volumes.

• Prostates with infarction after PAE showed larger decreases in volume.

• A larger decrease in prostate volume is associated with clinical success.


Benign prostatic hyperplasia Prostate Therapeutic embolisation Magnetic resonance imaging Anatomy, cross-sectional 



Benign prostatic hyperplasia


Central gland


Dynamic contrast - enhanced magnetic resonance imaging


International Index of erectile function


International prostate symptom score


Lower urinary tract symptoms


Median lobe


Magnetic resonance imaging


Prostatic arterial embolisation


Proximal embolization first then embolize distal


Prostate-specific antigen


Post-voiding residual urine


Peripheral zone


Maximum urinary flow rate


Quality of life


Whole prostate volume



The scientific guarantor of this publication is Yen-Ting Lin, MD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Héléna Pereira kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. This study is a retrospective observational study performed at one single institute.


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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Yen-Ting Lin
    • 1
    • 5
    Email author
  • Grégory Amouyal
    • 1
  • Jean-Michel Correas
    • 1
    • 6
  • Héléna Pereira
    • 1
  • Olivier Pellerin
    • 1
    • 2
    • 3
  • Costantino Del Giudice
    • 1
  • Carole Déan
    • 1
  • Nicolas Thiounn
    • 4
  • Marc Sapoval
    • 1
    • 2
    • 3
  1. 1.Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional RadiologyParisFrance
  2. 2.Inserm (Institut national de la santé et de la recherche médicale) U970ParisFrance
  3. 3.Université Paris DescartesParisFrance
  4. 4.Assistance publique Hopitaux de Paris, Hôpital Européen Georges-Pompidou, UrologyParisFrance
  5. 5.Department of Radiology, Taichung Veterans General HospitalTaichung CityRepublic of China
  6. 6.Radiology DepartmentHôpital NeckerParisFrance

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