Computed Tomography for 4-Dimensional Angiography and Perfusion Imaging of the Prostate for Embolization Planning of Benign Prostatic Hyperplasia

Objectives The aim of this study was to evaluate the feasibility of a computed tomography (CT) protocol enabling the visualization of the prostatic artery (PA) before prostatic artery embolization (PAE) in benign prostatic hyperplasia, which provides quantitative perfusion information of the prostate gland. Materials and Methods In this institutional review board–approved study, 22 consecutive patients (mean age, 67 ± 7 years) who were planned to undergo PAE underwent a dynamic CT scan of the pelvis (scan range, 22.4 cm; cycle time, 1.5 seconds; scan time, 44 seconds; 25 scan cycles; 70 kVp; 100 mAs) after the administration of 70 mL of iodinated contrast media (flow rate, 6 mL/s; 10 seconds' delay). Image postprocessing consisted of a spatiotemporal, frequency-depending multiband filtering technique with noise reduction, motion correction, resulting in (1) time-resolved, temporal maximum intensity projection (MIP) images from fusion of multiple arterial time points; (2) 4-dimensional (4D) CT angiography images after bone and calcium plaque removal; and (3) parametric perfusion maps of the prostate. Intraprocedural cone-beam CT was performed with a microcatheter in the PA. In both modalities, the contrast-to-noise ratio of the right internal iliac artery or the PA was calculated, respectively. Visibility of the PA was scored using a Likert scale (score 1 = not seen, to score 4 = intraprostatic PA branches seen). Quantitative perfusion analysis of the dynamic...
Source: Investigative Radiology - Category: Radiology Tags: Original Articles Source Type: research

Related Links:

To analyze the safety of mirabegron add-on therapy in men with overactive bladder symptoms concurrently receiving tamsulosin for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
AbstractPurposeTo present our experience of the patterns of revascularisation of the prostate and efficacy of repeat prostate artery embolisation (rPAE) in patients with recurrence of lower urinary tract symptoms.Materials and MethodsWe retrospectively analysed 12 patients who underwent rPAE at a single centre between November 2015 and March 2020. The patients had their intraprocedural angiography and cone beam CT images as well as their pre-procedural CT retrospectively reviewed to establish the patterns of revascularisation. Clinical follow-up occurred at a minimum of 3  months.Results11/12 patients (91.6%) had sign...
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
This study aimed to examine the effects of AQP5 on estrogen-induced EMT in the prostate. METHODS: Normal prostate (NP) tissue samples without any histopathological changes and BPH tissue samples with pathologically confirmed hyperplasia were obtained. An EMT cell model was subsequently established by adding estradiol (E2) to RWPE-1 cells, after which AQP5 knockdown was performed. Tissue morphological and immunohistochemical features were examined using hematoxylin-eosin and immunohistochemical staining. Western blot analysis was performed to determine the expression of AQPs, estrogen receptors, and EMT-related protein...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
As Prostate Artery Embolization (PAE) for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH) becomes more commonly performed, operator knowledge of the adverse events is essential to inform patient selection, patient preparation, and post-procedural management. The aim of this article is to the discuss the incidence, presentation, and management of the PAE adverse effects.
Source: Techniques in Vascular and Interventional Radiology - Category: Radiology Authors: Source Type: research
AbstractPurposeTo investigate the safety and effectiveness of superselective prostatic artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH).MethodsSixty-five patients diagnosed with BPH in Fujian Provincial Hospital between December 2014 and July 2019 were included. Patients with ineffective drug treatment after 6  months, who refused surgery, or who were unsuitable for surgery were included. We observed postoperative complications, followed up at 1, 3, and 6 months, compared clinical symptoms, and monitored changes in prostate-specific antigen (PSA) and prostatic volume (PV) before and a...
Source: Abdominal Imaging - Category: Radiology Source Type: research
Prostate artery embolization (PAE) is a minimally invasive treatment option for benign prostatic hyperplasia (BPH) associated lower urinary tract symptoms (LUTS) (1-7). Operators require a detailed understanding of the prostate arterial anatomy (origins and collaterals) to ensure technical and clinical success with minimal complications (8). Because of the high variability in pelvic vascular anatomy, several classification systems have been developed to better identify and characterize prostate arteries.
Source: Techniques in Vascular and Interventional Radiology - Category: Radiology Authors: Source Type: research
In conclusion, this study provides novel evidence that febuxostat experimentally attenuates testosterone-induced BPH in rats, at least in part by inhibiting iNOS/COX-2 and VEGF/TGF-β pathways. PMID: 33031799 [PubMed - as supplied by publisher]
Source: European Journal of Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Eur J Pharmacol Source Type: research
Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) occur in 50% of men over the age of 50 years, and prevalence increases with age. Patients traditionally have been managed with a combination of medical and surgical treatments. Transurethral resection of the prostate (TURP) is the gold standard for surgical treatment of BPH. Within the past decade, prostate artery embolization (PAE) has emerged as a minimally invasive alternative for the treatment of BPH, urinary retention, and hematuria of prostatic origin.
Source: Techniques in Vascular and Interventional Radiology - Category: Radiology Authors: Source Type: research
Medically refractory benign prostatic hyperplasia (BPH) induced lower urinary tract symptoms (LUTS) is an extremely prevalent issue in older men. The current gold standard therapy transurethral resection of the prostate (TURP) does produce urologic improvements but is also associated with higher than desired morbidity. This has led to the need to develop new minimally invasive means to treat this disease; prostate artery embolization (PAE) has emerged as one minimally invasive treatment option for these patients.
Source: Techniques in Vascular and Interventional Radiology - Category: Radiology Authors: Source Type: research
Hematuria of prostatic origin has multiple etiologies including benign prostatic hyperplasia (BPH), iatrogenic urological trauma, prostate cancer, and radiation therapy. Hematuria secondary to benign prostatic hyperplasia (BPH) can occur because of the increased vascularity of the primary gland, itself, or because of the vascular re-growth following a transurethral resection of the prostate. Prostatic hematuria usually resolves with conservative measures; however, refractory hematuria of prostatic origin (RHPO) may require hospitalization with treatment with blood transfusions, repeated indwelling urinary catheterization, ...
Source: Techniques in Vascular and Interventional Radiology - Category: Radiology Authors: Source Type: research
More News: Angiography | Benign Prostatic Hyperplasia | Calcium | CT Scan | Perfusion | PET Scan | Radiology | Study