de Assis André Moreira, Maciel Macello Sampaio, Moreira Airton Mota, de Paula Rodrigues Vanessa Cristina, Antunes Alberto Azoubel, Srougi Miguel, Cerri Giovanni Guido, Carnevale Francisco Cesar
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.
Urology Department, University of Sao Paulo Medical School, Dr. Enéas de Carvalho Aguiar Avenue, 255, Cerqueira César, São Paulo, SP, 05403-000, Brazil.
Cardiovasc Intervent Radiol. 2017 Feb;40(2):245-251. doi: 10.1007/s00270-016-1518-8. Epub 2016 Nov 21.
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).
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.
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.
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.
确定前列腺基线分区容积，并将这些结果与因良性前列腺增生（BPH）导致下尿路症状（LUTS）而接受前列腺动脉栓塞术（PAE）的患者的临床结局相关联。
这是一项回顾性研究，纳入了2010年至2014年接受PAE治疗的患者。基线和6个月随访评估包括全前列腺（WP）和中央腺体（CG）体积测量的前列腺MRI，以及前列腺分区容积指数（ZVi）计算，定义为CG/WP体积关系、国际前列腺症状评分（IPSS）和生活质量（QoL）指数。将基线WP、CG和ZVi与6个月时的IPSS和QoL值进行统计学比较。
共纳入93例连续患者，平均年龄63.4岁（范围51 - 86岁）。4例（4.3%）出现临床失败，定义为IPSS > 7或QoL > 2。PAE后WP和CG的前列腺体积平均分别减少30.6%和31.2%（p < 0.0001）。临床参数方面，IPSS平均从21分降至3.3分，QoL平均从4.7分降至1.2分（p < 0.0001）。基线WP、CG和ZVi与临床改善程度相关（所有p < 0.05）。为获得更好临床结局计算出的基线ZVi临界值> 0.45，敏感性为85%，特异性为75%。
基线CG和WP体积以及ZVi与接受PAE的患者的临床结局密切相关，在可能的情况下，预处理评估中应考虑对其进行评估。当ZVi < 0.45时，患者和医疗团队都应意识到可能出现不太理想结局的可能性。
