1. Role of Ultrasound Elastography in Patient Selection for Prostatic Artery Embolization.
- Author
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de Assis AM, Moreira AM, Carnevale FC, Zafred Marcelino AS, Antunes AA, Srougi M, and Cerri GG
- Subjects
- Arteries diagnostic imaging, Humans, Male, Patient Selection, Prospective Studies, Prostate diagnostic imaging, Quality of Life, Treatment Outcome, Elasticity Imaging Techniques, Embolization, Therapeutic adverse effects, Lower Urinary Tract Symptoms therapy, Prostatic Hyperplasia complications, Prostatic Hyperplasia diagnostic imaging, Prostatic Hyperplasia therapy
- Abstract
Purpose: To determine the effects of prostatic artery embolization (PAE) on prostate elasticity as assessed using ultrasound elastography (US-E) and to describe baseline US-E's potential role in patient selection., Materials and Methods: This was a prospective investigation that included 20 patients undergoing PAE to treat lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH). US-E with measurement of the prostatic elastic modulus (EM) and shear wave velocity (SWV) was performed before PAE and at 1-month follow-up. Baseline, 3-month, and 1-year follow-up evaluations included prostate-specific antigen, uroflowmetry, pelvic magnetic resonance imaging, and clinical assessment using the International Prostate Symptom Score (IPSS) and quality of life (QoL) metrics., Results: Seventeen patients entered statistical analysis. US-E showed a significant reduction in mean prostatic EM (34.4 kPa vs 46.3 kPa, -24.7%, P < .0001) and SWV (3.55 m/s vs 4.46 m/s, -20.0%, P < .0001) after PAE. There were moderate positive correlations between baseline EM and 1-year IPSS (R = 0.62, P = .007) and between baseline SWV and 1-year IPSS (R = 0.68, P = .002). Baseline SWV ≥ 5.59 m/s and baseline EM ≥ 50.14 kPa were associated with suboptimal IPSS and QoL outcomes after PAE with high degrees of sensitivity (100%) and specificity (69-100%)., Conclusions: PAE led to a positive effect on the BPH dynamic component related to prostatic elasticity. There was a moderate positive correlation between baseline prostatic elastographic parameters and 12-month IPSS. Measurement of baseline elastographic characteristics may become useful for the evaluation and selection of patients for PAE., (Copyright © 2021 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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