title: Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE.
abstract: OBJECTIVE
  To assess the impact of prostatic arterial embolisation (PAE) on various prostate gland anatomical zones.
  
  
  METHODS
  We retrospectively reviewed paired MRI scans obtained before and after PAE for 25 patients and evaluated changes in volumes of the median lobe (ML), central gland (CG), peripheral zone (PZ) and whole prostate gland (WPV) following PAE. We used manual segmentation to calculate volume on axial view T2-weighted images for ML, CG and WPV. We calculated PZ volume by subtracting CG volume from WPV. Enhanced phase on dynamic contrasted-enhanced MRI was used to evaluate the infarction areas after PAE. Clinical results of International Prostate Symptom Score and International Index of Erectile Function questionnaires and the urodynamic study were evaluated before and after PAE.
  
  
  RESULTS
  Significant reductions in volume were observed after PAE for ML (26.2 % decrease), CG (18.8 %), PZ (16.4 %) and WPV (19.1 %; p < 0.001 for all these volumes). Patients with clinical failure had smaller volume reductions for WPV, ML and CG (all p < 0.05). Patients with significant CG infarction after PAE displayed larger WPV, ML and CG volume reductions (all p < 0.01).
  
  
  CONCLUSIONS
  PAE can significantly decrease WPV, ML, CG and PZ volumes, and poor clinical outcomes are associated with smaller volume reductions.
  
  
  CONCLUSIONS
  • The MRI segmentation method provides detailed comparisons of prostate volume change. • Prostatic arterial embolisation (PAE) decreased central gland and peripheral zone volumes. • Prostates with infarction after PAE showed larger decreases in volume. • A larger decrease in prostate volume is associated with clinical success.
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France. ymerically@gmail.com.|Department of Radiology, Taichung Veterans General Hospital, No.1650, Taiwan Boulevard Sect. 4, Taichung City, Taiwan, Republic of China. ymerically@gmail.com.
authors.forename: Yen-Ting
authors.initials: YT
authors.lastname: Lin
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Amouyal
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France.|Radiology Department, Hôpital Necker, 149 rue de Sèvres, 75015, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Correas
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Héléna
authors.initials: H
authors.lastname: Pereira
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France.|Inserm (Institut national de la santé et de la recherche médicale) U970, 56 rue Leblanc, 75015, Paris, France.|Université Paris Descartes, Sorbonne Paris-Cité, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Pellerin
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Costantino
authors.initials: C
authors.lastname: Del Giudice
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Déan
authors.affiliation: Assistance publique Hopitaux de Paris, Hôpital Européen Georges-Pompidou, Urology, 20 rue Leblanc, 75015, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Thiounn
authors.affiliation: Assistance publique Hôpitaux de Paris. Hôpital Européen Georges-Pompidou, Vascular and Oncological Interventional Radiology, 20 rue Leblanc, 75015, Paris, France.|Inserm (Institut national de la santé et de la recherche médicale) U970, 56 rue Leblanc, 75015, Paris, France.|Université Paris Descartes, Sorbonne Paris-Cité, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Sapoval
mesh_terms: D000368:Aged; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D007089:Image Enhancement; D007238:Infarction; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: Anatomy, cross-sectional; Benign prostatic hyperplasia; Magnetic resonance imaging; Prostate; Therapeutic embolisation