Visualisation of periprostatic neurovascular bundles before and after radical prostatectomy by means of diffusion tensor imaging (DTI), with clinical correlations

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2017

Poster Number:

C-2924

Type:

Scientific Exhibit

Keywords:

Pelvis, Genital / Reproductive system male, MR, MR-Diffusion/Perfusion, Diagnostic procedure, Computer Applications-Detection, diagnosis, Neoplasia

Authors:

A. J. Cybulski¹, V. Di Paola², R. Negrelli¹, S. Brancato¹, E. Boninsegna¹, R. Manfredi¹, R. Pozzi-Mucelli¹; ¹Verona/IT, ²Legnano/IT

DOI:

10.1594/ecr2017/C-2924

DOI-Link:

https://dx.doi.org/10.1594/ecr2017/C-2924

Table 1: MRI protocol for the study of the prostate.

Fig. 1: ROI in the periprostatic fat tissue before radical prostatectomy: base (A), mid...

Fig. 2: ROI in the periprostatic fat tissue after radical prostatectomy: base (A), mid...

Table 2: Table and Graph: number of fiber tracts before and after RP.

Aims and objectives

Prostate cancer is the most common malignant neoplasm in males, accounting for the 25% of all tumors and it is the second cause of death due to cancer. There are many treatments for the prostatic cancer such as hormone therapy and radiotherapy, but the treatment of choice of locally advanced and aggressive form of prostatic cancer is represented by radical prostatectomy (RP). Unfortunately this major surgery is related to some complications such as urinary incontinence and erectile dysfunction that reduce patient's quality of life. In...

Methods and materials

Twenty-five patients (mean age 64.8ys) with biopsy-proven prostate cancer underwent MRI including DTI sequence before and after RP between February 2014 and August 2016. All DTI exams were performed on a 1.5-T MR unit (Ingenia; Philips Medical Systems, Eindhoven, Netherlands) using a multichannel phased array (16 + 16 channel coil) for signal reception. Peristalsis was suppressed by intramuscular administration of 20 mg of scopolamine. Before to start examination, patients were asked to have half-filled bladder to limit involuntary movements. The dynamic imaging was performed during...

Results

NUMBER OF FIBERS BEFORE AND AFTER RP The mean values of the numbers of fiber tracts before and after RP at base, mid gland, and apex levels for right and left side are reported in Table II and in the associated Graphic.The number of fiber tracts decreased after RP at base, midgland, and apex for both right and left sides; the decrease was statistically significant for all these sites (p<0.01) (Fig. 3). LENGTH OF FIBERS BEFORE AND AFTER RP The mean values of the length...

Conclusion

Diffusion Tensor Imaging (DTI) of the periprostatic neurovascular fibers (PNFs) has demonstrated to be a useful technique to detect a statically significant decrease of the number (p<0.01) and of the FA values (p<0.05) of the PNFs after Radical Prostatectomy. The decrease of the number of the PNFs resulted statistically related to the decrease of post-surgical erectile dysfunction (p< 0.05), suggesting that it could be an important factor related to the post-surgical erectile dysfunction and a potential good and reproducible technique to evaluate RP functional outcome....

Personal information

References

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