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Preoperative detection and localization of accessory pudendal artery with contrast-enhanced MR angiography

Shin Young Whang1, Deuk Jae Sung, Seun Ah Lee

  • 1Departments of Radiology and Urology, Anam Hospital, Korea University, College of Medicine, 5-Ka Anam-dong, Sungbuk ku, Seoul 136-705, Korea.

Radiology
|February 24, 2012
PubMed
Abstract

Insights

Contrast-enhanced MR angiography effectively detects accessory pudendal arteries (APAs) before prostate cancer surgery. This imaging technique aids in precise localization, improving surgical planning for radical prostatectomy.

Area of Science:

  • Vascular imaging
  • Urologic oncology
  • Surgical anatomy

Background:

  • Accessory pudendal arteries (APAs) are anatomical variations potentially encountered during prostate cancer surgery.
  • Accurate preoperative identification of APAs is crucial for surgical planning and minimizing complications during radical prostatectomy.

Purpose of the Study:

  • To assess the diagnostic performance of contrast-enhanced magnetic resonance (MR) angiography for detecting and localizing accessory pudendal arteries (APAs) in patients with prostate cancer.

Main Methods:

  • Prospective study involving 127 patients undergoing contrast-enhanced MR angiography before robot-assisted laparoscopic radical prostatectomy (RALP).
  • APAs were defined and subclassified (apical, lateral).
  • MR angiograms were evaluated prospectively and retrospectively by multiple readers, with surgical findings as the reference standard.

Main Results:

  • 16 out of 19 APAs detected surgically were localized by preoperative contrast-enhanced MR angiography.
  • Prospective sensitivity, specificity, and accuracy were 81.3%, 93.7%, and 92.1%, respectively.
  • Retrospective performance showed high sensitivity and specificity, with substantial interreader agreement (k = 0.795).

Conclusions:

  • Contrast-enhanced MR angiography is a valuable tool for the preoperative detection and localization of APAs in prostate cancer patients.
  • This imaging modality can aid surgeons in planning RALP by identifying critical vascular structures.

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