title: Does Abstinence From Ejaculation Before Prostate MRI Improve Evaluation of the Seminal Vesicles?
abstract: OBJECTIVE
  The purpose of the present study is to determine whether abstinence from ejaculation before undergoing multiparametric prostate MRI increases seminal vesicle (SV) volume and therefore improves diagnostic interpretation of the SVs.
  
  
  METHODS
  This retrospective study included 238 patients who underwent 3-T MRI of the prostate over a 4-month period. Patients were requested to complete a questionnaire that asked how long it had been since their last ejaculation (i.e., < 3 days vs ≥ 3 days). Forty-two patients (mean patient age, 62.0 years) indicated that it had been less than 3 days since their last ejaculation and were designated as group 1, whereas the remainder indicated an interval of 3 days or more since their last ejaculation. A group of 42 age-matched subjects (mean patient age, 62.1 years) were randomly selected from the remaining 196 patients and were designated as group 2. SV volumes were measured manually. Two radiologists who were blinded to group assignment and patient characteristics scored the right and left SVs separately to determine diagnostic interpretability, which was scored on a 3-point scale as follows: a score of 1 denoted that the SVs were not dilated and the score was nondiagnostic, a score of 2 indicated that the SVs were not dilated but the score was diagnostic, and a score of 3 denoted that the SVs were dilated and the score was diagnostic. Volume differences and interpretability scores were analyzed using a t test. Interobserver agreement was analyzed using the Cohen kappa statistic. A separate analysis was performed to evaluate differences in diagnostic interpretability for patients 60 years and younger versus patients older than 60 years, by use of the chi-square test and relative risk ratio analysis.
  
  
  RESULTS
  The right, left, and total SV volumes for group 1 were 3.1 mL, 2.9 mL, and 6.0 mL, respectively, whereas those for group 2 were 4.7 mL, 4.1 mL, and 8.8 mL, respectively (p = 0.011). The mean interpretability scores for group 1 and group 2 were 2.0 and 2.5, respectively. For group 1, reader 1 and reader 2 assigned a nondiagnostic score for 10 and 13 patients, respectively, whereas for group 2, they assigned a nondiagnostic score for two and five patients, respectively (p = 0.01, for reader 1; and p = 0.03, for reader 2). For men in group 1 who were older than 60 years, reader 1 and reader 2 gave a nondiagnostic score for nine and 11 patients, respectively; whereas for men in group 2 who were older than 60 years, the readers gave a nondiagnostic score for two and five patients, respectively (p = 0.01, for reader 1; and p = 0.05, for reader 2).
  
  
  CONCLUSIONS
  For men older than 60 years, abstinence from ejaculation for 3 or more days before undergoing MRI examination resulted in larger SV volumes and lower rates of nondiagnostic evaluation and therefore might improve evaluation of SV invasion on multi-parametric MRI. The difference is less striking in men 60 years and younger.
authors.affiliation: 1 Department of Radiology, Hacettepe University, Ankara, Turkey.
authors.forename: Ismail M
authors.initials: IM
authors.lastname: Kabakus
authors.affiliation: 2 Department of Radiology, George Washington University, Washington, DC.
authors.forename: Samuel
authors.initials: S
authors.lastname: Borofsky
authors.affiliation: 3 Molecular Imaging Program, National Institutes of Health, 10 Center Dr, Bldg 10, Rm B3B85, Bethesda, MD 20892.
authors.forename: Francesca V
authors.initials: FV
authors.lastname: Mertan
authors.affiliation: 3 Molecular Imaging Program, National Institutes of Health, 10 Center Dr, Bldg 10, Rm B3B85, Bethesda, MD 20892.
authors.forename: Matthew
authors.initials: M
authors.lastname: Greer
authors.affiliation: 3 Molecular Imaging Program, National Institutes of Health, 10 Center Dr, Bldg 10, Rm B3B85, Bethesda, MD 20892.
authors.forename: Dagane
authors.initials: D
authors.lastname: Daar
authors.affiliation: 4 Department of Interventional Radiology, National Institutes of Health, Bethesda, MD.
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Wood
authors.affiliation: 5 Department of Urology, National Institutes of Health, Bethesda, MD.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
authors.affiliation: 3 Molecular Imaging Program, National Institutes of Health, 10 Center Dr, Bldg 10, Rm B3B85, Bethesda, MD 20892.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.affiliation: 3 Molecular Imaging Program, National Institutes of Health, 10 Center Dr, Bldg 10, Rm B3B85, Bethesda, MD 20892.
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
mesh_terms: D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging* / Q000502:physiology; D015203:Reproducibility of Results; D012669:Seminal Vesicles / Q000000981:diagnostic imaging* / Q000502:physiology; D012680:Sensitivity and Specificity; D012746:Sexual Abstinence / Q000502:physiology*
keywords: MRI; ejaculation; prostate; seminal vesicles