title: In vivo 3D neuroanatomical evaluation of periprostatic nerve plexus with 3T-MR Diffusion Tensor Imaging.
abstract: OBJECTIVE
  To evaluate if Diffusion Tensor Imaging technique (DTI) can improve the visualization of periprostatic nerve fibers describing the location and distribution of entire neurovascular plexus around the prostate in patients who are candidates for prostatectomy.
  
  
  METHODS
  Magnetic Resonance Imaging (MRI), including a 2D T2-weighted FSE sequence in 3 planes, 3D T2-weighted and DTI using 16 gradient directions and b=0 and 1000, was performed on 36 patients. Three out of 36 patients were excluded from the analysis due to poor image quality (blurring N=2, artifact N=1). The study was approved by local ethics committee and all patients gave an informed consent. Images were evaluated by two radiologists with different experience in MRI. DTI images were analyzed qualitatively using dedicated software. Also 2D and 3D T2 images were independently considered.
  
  
  RESULTS
  3D-DTI allowed description of the entire plexus of the periprostatic nerve fibers in all directions, while 2D and 3D T2 morphological sequences depicted part of the fibers, in a plane by plane analysis of fiber courses. DTI demonstrated in all patients the dispersion of nerve fibers around the prostate on both sides including the significant percentage present in the anterior and anterolateral sectors.
  
  
  CONCLUSIONS
  DTI offers optimal representation of the widely distributed periprostatic plexus. If validated, it may help guide nerve-sparing radical prostatectomy.
authors.affiliation: Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy. valeria.panebianco@gmail.com
authors.forename: Valeria
authors.initials: V
authors.lastname: Panebianco
authors.forename: Flavio
authors.initials: F
authors.lastname: Barchetti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciarra
authors.forename: Andrea
authors.initials: A
authors.lastname: Marcantonio
authors.forename: Chiara
authors.initials: C
authors.lastname: Zini
authors.forename: Stefano
authors.initials: S
authors.lastname: Salciccia
authors.forename: Federico
authors.initials: F
authors.lastname: Collettini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Gentile
authors.forename: Bernard
authors.initials: B
authors.lastname: Hamm
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
mesh_terms: D000368:Aged; D000465:Algorithms; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D010525:Peripheral Nerves / Q000473:pathology*; D011467:Prostate / Q000294:innervation* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Diffusion MRI; Diffusion Tensor Imaging; Erectile disfunction; Prostate cancer; Prostatectomy