title: Embolization therapy for benign prostatic hyperplasia: influence of embolization particle size on gland perfusion.
abstract: OBJECTIVE
  To assess the influence of embolic size on the therapy response of prostatic arterial embolization (PAE) based on perfusional changes seen on dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI).
  
  
  METHODS
  Twelve beagles underwent PAE, four dogs with each particle size: A: 100-300 μm; B: 300-500 μm; and C: 500-700 μm. Prior to and 1 month after the embolization all dogs underwent prostate DCE MRI.
  
  
  RESULTS
  After embolization, time to maximal perfusion intensity for prostate parenchyma increased in B (188 vs. 135 sec, P = 0.023) and C (200 vs. 120 sec, P = 0.001), while it did not change for A (139 vs. 124 sec, P = 0.39). The maximal relative intensity increased after embolization in C (3.84 vs. 2.38, P < 0.001), while it did not change for A (2.50 vs. 2.44, P = 0.36) and B (3.23 vs. 2.9, P = 0.21). The extent of visualized intraprostatic urethral wall increased after embolization in B compared with A and C, 239.5 ± 138.1% vs. 56.1 ± 34.3, P = 0.04. Enhancement changes correlated with prostate volume changes: prostate volumes in A decreased less as compared with B and C (77 ± 34% vs. 56 ± 14%), P = 0.02.
  
  
  CONCLUSIONS
  The enhancement and morphological data are useful to monitor response to therapy after embolization. Embolization with 300-500 and 500-700 μm particle may provide better results than with 100-300 μm particles in a canine model.
authors.affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. obrook@bidmc.harvard.edu
authors.forename: Olga Rachel
authors.initials: OR
authors.lastname: Brook
authors.forename: Salomao
authors.initials: S
authors.lastname: Faintuch
authors.forename: Alexander
authors.initials: A
authors.lastname: Brook
authors.forename: S Nahum
authors.initials: SN
authors.lastname: Goldberg
authors.forename: Neil M
authors.initials: NM
authors.lastname: Rofsky
authors.forename: Robert E
authors.initials: RE
authors.lastname: Lenkinski
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D004285:Dogs; D004621:Embolization, Therapeutic / Q000379:methods*; D005780:Gelatin / Q000737:chemistry / Q000627:therapeutic use*; D006490:Hemostatics / Q000737:chemistry / Q000627:therapeutic use; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D011467:Prostate / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D005780:Gelatin