Evaluation of periprostatic neurovascular fibers before and after radical prostatectomy by means of 1.5 T MRI diffusion tensor imaging

Valerio Di Paola, Adam Cybulski, Salvatore Belluardo, Francesca Cavicchioli, Riccardo Manfredi, Roberto Pozzi Mucelli

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate if diffusion tensor imaging (DTI) is able to detect changes of periprostatic neurovascular fibers (PNFs) before and after radical prostatectomy (RP), and if these changes are related to post-surgical urinary incontinence and erectile dysfunction. Methods: 22 patients (mean age 62.6 years) with biopsy- proven prostate cancer underwent 1.5 T DTI before and after RP. The number, fractional anisotropy (FA) values and length of PNFs before and after RP were compared using Student's t-test. Each patient filled out two questionnaires before and after RP, one for the evaluation of urinary continence (ICIQ-SF) and one for the evaluation of erectile function (IIEF-5). The ratios of the number, FA values and length of PNFs before and after RP (DTI B-A RATIOs) and the ratios between the scores obtained before and after RP for both ICIQ-SF and IIEF-2 (ICIQ-SF B-A RATIOs and IIEF-2 B-A RATIOs) were calculated to perform the Kendall's ρ-test between them. Results: There was a statistically significant decrease of the number of PNFs after RP at base, midgland, and apex (p < 0.01) and of FA values at midgland (p < 0.05), with positive statistically significant correlation between the DTI B-A RATIOs of the number of PNFs and IIEF-2 B-A RATIOs (p < 0.05, ρ = 0.47). Conclusion: DTI was able to detect that the decrease of the number of the PNFs after RP was statistically related to the post-surgical erectile dysfunction (p < 0.05). Advances in knowledge: This work demonstrates that: (1) 1.5 T MRI DTI is able to detect the decrease of the number and of the FA of PNFs after prostatectomy; (2) the decrease of the number of PNFs after prostatectomy is related with the post-surgical erectile dysfunction; (3) 1.5 T MRI DTI has demonstrated to be a reproducible technique in detecting the changes of the PNFs induced by RP, with high interobserver agreement.

Original languageEnglish
Article number20170318
JournalBritish Journal of Radiology
Volume91
Issue number1085
DOIs
Publication statusPublished - Jan 1 2018

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Diffusion Tensor Imaging
Prostatectomy
Anisotropy
Erectile Dysfunction
Urinary Incontinence
Prostatic Neoplasms
Students

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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Evaluation of periprostatic neurovascular fibers before and after radical prostatectomy by means of 1.5 T MRI diffusion tensor imaging. / Di Paola, Valerio; Cybulski, Adam; Belluardo, Salvatore; Cavicchioli, Francesca; Manfredi, Riccardo; Mucelli, Roberto Pozzi.

In: British Journal of Radiology, Vol. 91, No. 1085, 20170318, 01.01.2018.

Research output: Contribution to journalArticle

Di Paola, Valerio ; Cybulski, Adam ; Belluardo, Salvatore ; Cavicchioli, Francesca ; Manfredi, Riccardo ; Mucelli, Roberto Pozzi. / Evaluation of periprostatic neurovascular fibers before and after radical prostatectomy by means of 1.5 T MRI diffusion tensor imaging. In: British Journal of Radiology. 2018 ; Vol. 91, No. 1085.
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AU - Di Paola, Valerio

AU - Cybulski, Adam

AU - Belluardo, Salvatore

AU - Cavicchioli, Francesca

AU - Manfredi, Riccardo

AU - Mucelli, Roberto Pozzi

PY - 2018/1/1

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N2 - Objective: To evaluate if diffusion tensor imaging (DTI) is able to detect changes of periprostatic neurovascular fibers (PNFs) before and after radical prostatectomy (RP), and if these changes are related to post-surgical urinary incontinence and erectile dysfunction. Methods: 22 patients (mean age 62.6 years) with biopsy- proven prostate cancer underwent 1.5 T DTI before and after RP. The number, fractional anisotropy (FA) values and length of PNFs before and after RP were compared using Student's t-test. Each patient filled out two questionnaires before and after RP, one for the evaluation of urinary continence (ICIQ-SF) and one for the evaluation of erectile function (IIEF-5). The ratios of the number, FA values and length of PNFs before and after RP (DTI B-A RATIOs) and the ratios between the scores obtained before and after RP for both ICIQ-SF and IIEF-2 (ICIQ-SF B-A RATIOs and IIEF-2 B-A RATIOs) were calculated to perform the Kendall's ρ-test between them. Results: There was a statistically significant decrease of the number of PNFs after RP at base, midgland, and apex (p < 0.01) and of FA values at midgland (p < 0.05), with positive statistically significant correlation between the DTI B-A RATIOs of the number of PNFs and IIEF-2 B-A RATIOs (p < 0.05, ρ = 0.47). Conclusion: DTI was able to detect that the decrease of the number of the PNFs after RP was statistically related to the post-surgical erectile dysfunction (p < 0.05). Advances in knowledge: This work demonstrates that: (1) 1.5 T MRI DTI is able to detect the decrease of the number and of the FA of PNFs after prostatectomy; (2) the decrease of the number of PNFs after prostatectomy is related with the post-surgical erectile dysfunction; (3) 1.5 T MRI DTI has demonstrated to be a reproducible technique in detecting the changes of the PNFs induced by RP, with high interobserver agreement.

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