title: Prostate Zonal Volumetry as a Predictor of Clinical Outcomes for Prostate Artery Embolization.
abstract: OBJECTIVE
  To determine prostate baseline zonal volumetry and correlate these findings with clinical outcomes for patients who underwent prostate artery embolization (PAE) for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).
  
  
  METHODS
  This is a retrospective study that included patients treated by PAE from 2010 to 2014. Baseline and 6-month follow-up evaluations included prostate MRI with whole prostate (WP) and central gland (CG) volume measurements-as well as prostate zonal volumetry index (ZVi) calculation, defined as the CG/WP volumes relation-the International Prostate Symptom Score (IPSS), and the Quality of life (QoL) index. Baseline WP, CG, and ZVi were statistical compared to IPSS and QoL values at 6 months.
  
  
  RESULTS
  A total of 93 consecutive patients were included, with mean age of 63.4 years (range, 51-86). Clinical failure, defined as IPSS > 7 or QoL > 2, was seen in four cases (4.3%). Mean reductions in prostate volumes after PAE were of 30.6% and 31.2% for WP and CG, respectively (p < 0.0001). Clinical parameters had mean decrease from 21 to 3.3 points for IPSS, and from 4.7 to 1.2 points for QoL (p < 0.0001). Baseline WP, CG, and ZVi correlated to the degree of clinical improvement (p < 0.05 for all). The baseline ZVi cut-off calculated for better clinical outcomes was > 0.45, with 85% sensitivity and 75% specificity.
  
  
  CONCLUSIONS
  Baseline CG and WP volumes as well as ZVi presented strong correlation with clinical outcomes in patients undergoing PAE, and its assessment should be considered in pre-treatment evaluation whenever possible. Both patients and medical team should be aware of the possibility of less favorable outcomes when ZVi < 0.45.
authors.affiliation: Vascular and Interventional Radiology Unit, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil. andre.assis@criep.com.br.
authors.forename: André Moreira
authors.initials: AM
authors.lastname: de Assis
authors.affiliation: Vascular and Interventional Radiology Unit, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
authors.forename: Macello Sampaio
authors.initials: MS
authors.lastname: Maciel
authors.affiliation: Vascular and Interventional Radiology Unit, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
authors.forename: Airton Mota
authors.initials: AM
authors.lastname: Moreira
authors.affiliation: Vascular and Interventional Radiology Unit, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
authors.forename: Vanessa Cristina
authors.initials: VC
authors.lastname: de Paula Rodrigues
authors.affiliation: Urology Department, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
authors.forename: Alberto Azoubel
authors.initials: AA
authors.lastname: Antunes
authors.affiliation: Urology Department, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.affiliation: Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
authors.forename: Giovanni Guido
authors.initials: GG
authors.lastname: Cerri
authors.affiliation: Vascular and Interventional Radiology Unit, Radiology Institute, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
authors.forename: Francisco Cesar
authors.initials: FC
authors.lastname: Carnevale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000098:blood supply* / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000150:complications*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Benign prostatic hyperplasia; Embolization; Imaging; Interventional radiology; Prostate artery embolization