Brook OR, Faintuch S, Brook A, Goldberg SN, Rofsky NM, Lenkinski RE. Embolization therapy for benign prostatic hyperplasia: influence of embolization particle size on gland perfusion.
J Magn Reson Imaging 2012;
38:380-7. [PMID:
23239260 DOI:
10.1002/jmri.23981]
[Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 11/06/2012] [Indexed: 12/28/2022] Open
Abstract
PURPOSE
To assess the influence of embolic size on the therapy response of prostatic arterial embolization (PAE) based on perfusional changes seen on dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI).
MATERIALS AND METHODS
Twelve beagles underwent PAE, four dogs with each particle size: A: 100-300 μm; B: 300-500 μm; and C: 500-700 μm. Prior to and 1 month after the embolization all dogs underwent prostate DCE MRI.
RESULTS
After embolization, time to maximal perfusion intensity for prostate parenchyma increased in B (188 vs. 135 sec, P = 0.023) and C (200 vs. 120 sec, P = 0.001), while it did not change for A (139 vs. 124 sec, P = 0.39). The maximal relative intensity increased after embolization in C (3.84 vs. 2.38, P < 0.001), while it did not change for A (2.50 vs. 2.44, P = 0.36) and B (3.23 vs. 2.9, P = 0.21). The extent of visualized intraprostatic urethral wall increased after embolization in B compared with A and C, 239.5 ± 138.1% vs. 56.1 ± 34.3, P = 0.04. Enhancement changes correlated with prostate volume changes: prostate volumes in A decreased less as compared with B and C (77 ± 34% vs. 56 ± 14%), P = 0.02.
CONCLUSION
The enhancement and morphological data are useful to monitor response to therapy after embolization. Embolization with 300-500 and 500-700 μm particle may provide better results than with 100-300 μm particles in a canine model.
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