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Abstract
ObjectiveTo prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days.Methods15 healthy male volunteers (mean 35.9 years, range 27–53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner.ResultsAll subjects completed the four MRIs. Mean prostate volume was 22.45 cm3 (range 13.04–31.21 cm3), with no change between the four studies (p = 0.89–0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm3 (−25.6%, p < 0.001), and a significant reduction from baseline to day 2 (−18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 × 10−3 mm2/s at day 1 (mean −4.3%, p = 0.009).ConclusionThe longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI.Key Points• Seminal vesicle volume significantly reduced 24 h post-ejaculation remaining reduced at day 2• Seminal vesicle fluid volume significantly increased from day 1 to day 3 post-ejaculation• There was a significant reduction in whole-gland prostate ADC values day 1 post-ejaculation• 3-day abstinence from ejaculation is required to ensure maximal seminal vesicle distension
Highlights
Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Multiparametric MRI is increasingly being used for detection, localisation and staging of prostate cancer [1]
This study demonstrates the longitudinal MR measurements of seminal vesicle fluid volume following ejaculatory abstinence
The overall results suggest that a period of abstinence from ejaculation is warranted prior to prostate MRI
Summary
Multiparametric MRI is increasingly being used for detection, localisation and staging of prostate cancer [1]. Determining whether tumour extends into the seminal vesicles (T3b disease) is a key component for prostate cancer staging, with implications for risk stratification, management and longerterm prognosis. Seminal vesicle (SV) distension may be important for radiation therapy planning: target volumes for radical radiotherapy treatment incorporate the proximal 2 cm of SV in low- to intermediate-risk patients. Eur Radiol (2017) 27:5236–5243 or the entire seminal vesicles in patients with high-risk disease or suspected T3b involvement [3]. The target volume will be defined by the degree of SV distension and may subsequently change between radiotherapy sessions if prior ejaculatory status has an effect
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