Genitourinary, Anatomy, Neuroradiology peripheral nerve, MR, MR-Angiography, Intraoperative, Segmentation, Cancer, Prospective, Experimental, Multicentre study
I. Pyatnitskiy1, O. A. Vorontsov1, R. Ovchinnikov1, V. Mitrokhin1, R. Marishin1, E. Kharlamov2, B. Aleksandrov1, S. Droupy3, V. Medvedev4; 1Moscow/RU, 2Oslo/NO, 3Nîmes/FR, 4Krasnodar/RU
In vivo imaging and preoperative precise mapping of erectile nerves such as cavernous (CN) can help to improve their preservation during pelvic surgeries  such as prostate cancer surgery and thus help in preserving patient’s erectile function [2-4]. Such mapping is particularly challenging since individual CN are microscopic in size (100–400 μm) and their number, topology, and location (ventral, dorsal, or lateral) can significantly differ from one patient to another [5,6]. A variety of techniques have been developed to identify CN and study their anatomy and physiology, including electrical and optical nerve stimulation, dye-based optical fluorescence and microscopy, spectroscopy, ultrasound and magnetic resonance imaging. Some of these methods have potential for intraoperative use for identifying and preserving CN . However, results of their use are not satisfactory so far since the ratio of patients that develop post-surgical erectile disfunction is high [2,4].
The aim of our study is to develop a methodology to map terminal branches of the pelvic plexus including CN and vessels from the prostate and to the crus of the penis. In clinical practice such patient-specific mapping can help in preoperative planning and intraoperative navigation via virtual surgical exploration.