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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

Authors
  • de Assis, André Moreira1, 2
  • Moreira, Airton Mota1, 2
  • Carnevale, Francisco Cesar1, 2
  • Marcelino, Antonio Sergio Zafred3
  • de Oliveira Cerri, Luciana Mendes3
  • Antunes, Alberto Azoubel4
  • Srougi, Miguel4
  • Cerri, Giovanni Guido3, 5
  • 1 University of Sao Paulo Medical School, Interventional Radiology Department, Radiology Institute, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil , São Paulo (Brazil)
  • 2 Sírio-Libanês Hospital, Interventional Radiology Department, Adma Jafet Street, 115 Bela Vista, São Paulo, SP, 01308-050, Brazil , São Paulo (Brazil)
  • 3 Sírio-Libanês Hospital, Radiology Department, Adma Jafet Street, 115, Bela Vista, São Paulo, SP, 01308-050, Brazil , São Paulo (Brazil)
  • 4 University of Sao Paulo Medical School, Urology Department, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil , São Paulo (Brazil)
  • 5 University of Sao Paulo Medical School, Radiology Institute, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil , São Paulo (Brazil)
Type
Published Article
Journal
CardioVascular and Interventional Radiology
Publisher
Springer-Verlag
Publication Date
Apr 16, 2019
Volume
42
Issue
7
Pages
1001–1007
Identifiers
DOI: 10.1007/s00270-019-02220-x
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeTo 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 MethodsThis 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.ResultsAfter 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).ConclusionsFindings 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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