You have accessJournal of UrologyImaging/Radiology II1 Apr 2014MP7-18 VISUALIZATION OF PERIPROSTATIC NERVE FIBERS BEFORE AND AFTER RADICAL PROSTATECTOMY USING DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING WITH TRACTOGRAPHY Hideaki Miyake, Kazuhiro Kitajima, Satoru Takahashi, Yoshiko Ueno, Kazuro Sugimura, and Masato Fujisawa Hideaki MiyakeHideaki Miyake More articles by this author , Kazuhiro KitajimaKazuhiro Kitajima More articles by this author , Satoru TakahashiSatoru Takahashi More articles by this author , Yoshiko UenoYoshiko Ueno More articles by this author , Kazuro SugimuraKazuro Sugimura More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.341AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Diffusion tensor imaging (DTI) and tractography have emerged as non-invasive MRI techniques providing in vivo information on neural pathway in the brain. Recently, this technology has also been adopted for mapping of periprostatic nerve fibers; however, there have not been any studies assessing the changes in nerve fibers by using this imaging modality before and after radical prostatectomy (RP) according to the type of surgical management of neurovascular bundle (NVB). The objective of this study was to evaluate whether the DTI technique with tractography can visualize changes in the numbers of periprostatic nerve fibers at different regions of the prostate on each side following nerve-sparing and non-nerve-sparing RPs. METHODS Fifty-two patients with clinically localized prostate cancer underwent 3-Tesla MRI including DTI before and after RP. The periprostatic nerves were analyzed by separately tracking the fibers to the left and right of the posterolateral sectors at the base, mid-gland and apex. The numbers of tracts were then calculated, and changes in the numbers of these nerve tracts on each side before and after nerve-sparing and non-nerve-sparing RPs were compared. In this series, preservation of NVB was generally carried out by the interfascial dissection. RESULTS Five patients were excluded from the analysis due to poor image quality, and 8 prostatic sectors, in which partial nerve-sparing surgery for resecting nerve fibers around the base area alone was undertaken, were also excluded; therefore, a total of 86 prostatic sectors were analyzed in this series. In 69 prostatic sectors subjected to non-nerve-sparing procedure, the numbers of tracts were significantly decreased at the base (218.8±198.8 vs. 60.5±88.7, p<0.0001), mid-gland (124.1±134.5 vs. 32.5±45.7, p<0.0001) and apex (103.1±127.4 vs. 29.1±57.1, p<0.0001). In 17 prostatic sectors subjected to nerve-sparing procedure, the numbers of tracts were not changed significantly at the base (170.5±139.7 vs. 127.7±146.0, p=0.078), mid-gland (134.3±140.8 vs. 83.7±58.3, p=0.067) and apex (64.1±68.4 vs. 62.3±61.9, p=0.46). CONCLUSIONS Although further assessment would be required, the DTI technique with tractography may be feasible for visualization of periprostatic nerve fibers; thefore, this imaging technique could be a useful modality to help guide accurate surgical procedure for managing NVB during both nerve-sparing and non-nerve-sparing RPs. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e73 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Hideaki Miyake More articles by this author Kazuhiro Kitajima More articles by this author Satoru Takahashi More articles by this author Yoshiko Ueno More articles by this author Kazuro Sugimura More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...