2298 ONCOLOGICAL AND FUNCTIONAL MANAGEMENT IN NERVE SPARING RADICAL PROSTATECTOMY: PERIPROSTATIC NEUROVASCULAR BUNDLES EVALUATION WITH MAGNETIC RESONANCE IMAGING AND PROSTATE MAPPING WITH SPECTROSCOPY

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology1 Apr 20112298 ONCOLOGICAL AND FUNCTIONAL MANAGEMENT IN NERVE SPARING RADICAL PROSTATECTOMY: PERIPROSTATIC NEUROVASCULAR BUNDLES EVALUATION WITH MAGNETIC RESONANCE IMAGING AND PROSTATE MAPPING WITH SPECTROSCOPY Alessandro Sciarra, Stefano Salciccia, Andrea Alfarone, Susanna Cattarino, Valeria Panebianco, Alessandro Gentilucci, Danilo Lisi, Ulderico Parente, Roberto Passariello, and Vincenzo Gentile Alessandro SciarraAlessandro Sciarra Rome, Italy More articles by this author , Stefano SalcicciaStefano Salciccia Rome, Italy More articles by this author , Andrea AlfaroneAndrea Alfarone Rome, Italy More articles by this author , Susanna CattarinoSusanna Cattarino Rome, Italy More articles by this author , Valeria PanebiancoValeria Panebianco Rome, Italy More articles by this author , Alessandro GentilucciAlessandro Gentilucci Rome, Italy More articles by this author , Danilo LisiDanilo Lisi Rome, Italy More articles by this author , Ulderico ParenteUlderico Parente Rome, Italy More articles by this author , Roberto PassarielloRoberto Passariello Rome, Italy More articles by this author , and Vincenzo GentileVincenzo Gentile Rome, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2544AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The utility of a specific protocol magnetic resonance imaging (MRI) pre or post radical prostatectomy (RRP) to evaluate oncological outcomes and integrity of the nervous periprostatic vascular bundle (NVB) has not previously been analyzed. The aim of the study is to combine a pre intervention MRI spectroscopy assessment for tumour location and introduce a sequence dedicated to MRI morphological assessment of NVB, in order to identify the cancerous invasion in the preoperative staging and anatomic and functional integrity after RRP with nerve sparing technique. Our goal is also to introduce a new MRI morphological alterations classification of the patterns of the NVB using the International Index Erectile Function questionnaire, 5 items (IIEF-5), as the reference standard for analysis of correlation METHODS 53 patients underwent a bilateral nerve-sparing radical retropubic prostatectomy for prostatic adenocarcinoma; pT2 pN0 were included in the analysis. Preoperative MRI spectroscopy and dynamic contrast-enhanced imaging were performed mapping the prostate cancer loci and their relationship with NVB and MRI evaluation of the NVB; post operatively at 1 6 and 12 months from the RRP, two MR sequences with 2D and 3D T2 TSE T2 weighted ISO for the analysis of post-intervention NVB. Both MRI sequences were evaluated independently by two radiologists who graded the morphological changes of the NVB in each sequence, using a 5-point classification of increasing seriousness. The IIEF 5 performed at the same intervals of follow-up and was used as a reference in the analysis of correlation and regression. RESULTS Both two radiologists, classifying the alterations of NVB with 2D T2 MR images, included 13.2% of patients in class 0, 11.3% in Class I, Class II 34%, 24.5% in Class III and Class IV 17%. Using MRI 3D T2 ISO sequences , the 43.3% of patients was included in class 0, 32% class I, class II 11.4%, 7.5% in class III and 5.8% in class IV. In all cases examined the correlation and regression analysis between the 3D T2 ISO classification and IIEF 5 questionnaire used as the reference standard, was statistically significant (p <0.001). CONCLUSIONS In our study, MRI allows to describe with good accuracy the relation between tumor and NVB preoperatively and to analyze the effect of intervention on the NVB postoperatively. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e921-e922 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alessandro Sciarra Rome, Italy More articles by this author Stefano Salciccia Rome, Italy More articles by this author Andrea Alfarone Rome, Italy More articles by this author Susanna Cattarino Rome, Italy More articles by this author Valeria Panebianco Rome, Italy More articles by this author Alessandro Gentilucci Rome, Italy More articles by this author Danilo Lisi Rome, Italy More articles by this author Ulderico Parente Rome, Italy More articles by this author Roberto Passariello Rome, Italy More articles by this author Vincenzo Gentile Rome, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...