MP33-13 IMPACT OF PROSTATIC URETHRAL LIFT DEVICE ON PROSTATE MR IMAGE QUALITY

Abstract

You have accessJournal of UrologyCME1 May 2022MP33-13 IMPACT OF PROSTATIC URETHRAL LIFT DEVICE ON PROSTATE MR IMAGE QUALITY Tarik Benidir, Ryan Ward, Justin Ream, Ethan Austhof, Eric Klein, Ismail Turkbey, and Andrei Purysko Tarik BenidirTarik Benidir More articles by this author , Ryan WardRyan Ward More articles by this author , Justin ReamJustin Ream More articles by this author , Ethan AusthofEthan Austhof More articles by this author , Eric KleinEric Klein More articles by this author , Ismail TurkbeyIsmail Turkbey More articles by this author , and Andrei PuryskoAndrei Purysko More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002587.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostatic urethral lift (PUL) using the UroLift device is a non-pharmacological treatment option for patients with symptomatic benign prostatic hyperplasia. Patients with this device can safely undergo prostate MRI, but the influence of this device on prostate MR image quality has not been assessed. The aim of this study is to evaluate prostate MR image quality in patients with UroLift. METHODS: This retrospective study included 43 adult men (mean age 65.2yrs; mean PSA 5.86 ng/mL) with UroLift who underwent prostate MRI at two institutions. Images from one of the institutions (n=36) were reviewed and scored based on severity of artifacts caused by the device on T2-weighted (T2W), Diffusion weighted images (DWI) and apparent diffusion coefficient (ADC) maps in the peripheral zone (PZ) and transition zone (TZ) using a 5-point scale (1 – no impact on interpretation; 5 – non-diagnostic). Total prostate gland volumes and the prostate volumes obscured by the artifacts on T2W, ADC maps and dynamic contrast enhanced (DCE) images were measured. The means of the scores assigned for severity of artifacts and percentage of gland volumes affected by the artifacts were calculated. T-test was used to compare differences in image quality scores. RESULTS: The average prostate volume was 59.1 cc (IQR: 42.7-79). The mean image quality scores were worse for DWI/ADC than T2W both in the PZ (1.7 vs 1, p=0.0001) and in the TZ (3.2 vs 1.7 p=0.001). Worse scores were observed on DWI/ADC in the TZ at the base and mid gland compared to the apex (means scores 3.8, 3.5 and 2.5, respectively; p <0.05). The mean prostate volumes obscured by artifact on T2W, ADC map and DCE were 3.3 cc (IQR:2.0-4.5), 16.2 cc (IQR:10.5-21.6) and 6.4 cc (IQR:3.4-7.3). The mean percentage of prostate volume obscured by artifacts on T2W, ADC map and DCE were 0.06 (95% CI 0.05 to 0.07), 0.3 (95% CI 0.25 to 0.35) and 0.11 (95% CI 0.08 to 0.14), respectively. CONCLUSIONS: UroLift causes artifacts that can affect prostate MRI interpretation, with greater impact in the TZ and on DWI/ADC maps (Figure 1). Men considering undergoing PUL procedure should be counseled on the negative impact of this device on quality of prostate MRI. Source of Funding: Cleveland Clinic imaging department © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e575 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tarik Benidir More articles by this author Ryan Ward More articles by this author Justin Ream More articles by this author Ethan Austhof More articles by this author Eric Klein More articles by this author Ismail Turkbey More articles by this author Andrei Purysko More articles by this author Expand All Advertisement PDF DownloadLoading ...