Embolization therapy for benign prostatic hyperplasia: influence of embolization particle size on gland perfusion

J Magn Reson Imaging. 2013 Aug;38(2):380-7. doi: 10.1002/jmri.23981. Epub 2012 Dec 12.

Abstract

Purpose: 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).

Materials and 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.

Conclusion: 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.

Keywords: benign prostatic hyperplasia; canine prostate; dynamic contrast enhanced MRI; prostatic artery embolization.

MeSH terms

  • Animals
  • Blood Flow Velocity
  • Dogs
  • Embolization, Therapeutic / methods*
  • Gelatin / chemistry
  • Gelatin / therapeutic use*
  • Hemostatics / chemistry
  • Hemostatics / therapeutic use
  • Magnetic Resonance Angiography / methods*
  • Male
  • Prostate / blood supply
  • Prostate / pathology
  • Prostate / physiopathology*
  • Prostatic Hyperplasia / pathology
  • Prostatic Hyperplasia / physiopathology*
  • Prostatic Hyperplasia / therapy*
  • Treatment Outcome

Substances

  • Hemostatics
  • Gelatin