Semi-Automatic MRI Feature Assessment in Small- and Medium-Volume Benign Prostatic Hyperplasia after Prostatic Artery...

Area of Science:

• Radiology
• Urology
• Medical Imaging Analysis

Background:

• Benign prostatic syndrome (BPS) significantly impacts quality of life.
• Prostatic artery embolization (PAE) is a treatment option for symptomatic BPS.
• Accurate assessment of treatment response is crucial for patient management.

Purpose of the Study:

• To evaluate the treatment response of BPS after PAE using semi-automatic MRI analysis.
• To compare semi-automatic MRI findings with clinical indexes.
• To validate a semi-automatic software for assessing volumetric and morphological changes post-PAE.

Main Methods:

• Prospective study of 27 BPS patients undergoing PAE.
• Semi-automatic MRI software used for central gland (CG) and total gland (TG) segmentation.
• Analysis of T1w, T2w, DWI signal intensities, intravesical prostatic protrusion (IPP), and prostatic volumes (CGV, TGV).
• Clinical indexes included International Prostate Symptom Score (IPSS) and ICIQ-UI SF.
• Statistical analysis using ANOVA, Bonferroni correction, and correlation.

Main Results:

• Significant reduction in TGV observed at 1, 6, and 12 months post-PAE (p = 0.005; p = 0.025).
• Significant decrease in IPP (p = 0.028; p = 0.010; p = 0.008) and improvement in IPSS/ICIQ-UI SF (p = 0.002; p = 0.016).
• Apparent diffusion coefficient (ADC) values in CG significantly decreased one month post-PAE (p < 0.001).

Conclusions:

• Semi-automatic MRI analysis is suitable for assessing volumetric and morphological changes after PAE.
• The method accurately identifies significant ADC value changes post-treatment.
• Semi-automatic TGV reduction correlates with clinical improvement, validating PAE's effectiveness.