PI-RADS 3-5 lesions MRI pattern after prostate artery embolization

Area of Science:

• Radiology
• Interventional Radiology
• Urology

Background:

• Prostate artery embolization (PAE) is a treatment for lower urinary tract symptoms.
• Prostate Magnetic Resonance Imaging (MRI) with PI-RADS scoring is used to assess suspicious lesions.
• Changes in PI-RADS scores after PAE require evaluation.

Purpose of the Study:

• To assess the evolution of PI-RADS ≥ 3 lesions on prostate MRI following PAE.
• To determine if PAE impacts the PI-RADS classification of pre-existing lesions.

Main Methods:

• Retrospective analysis of 18 patients who underwent PAE.
• Inclusion criteria: pre-PAE MRI with at least one PI-RADS ≥ 3 lesion.
• Assessment of PI-RADS score changes, infarction, and prostate volume on follow-up MRI.

Main Results:

• No new PI-RADS ≥ 3 lesions appeared post-PAE; no lesions were upgraded.
• PI-RADS 5 lesions were downgraded to PI-RADS 1.
• PI-RADS 4 and PI-RADS 3 lesions showed stability or downgrading, with some reaching PI-RADS 1 status.

Conclusions:

• PI-RADS ≥ 3 lesions on prostate MRI tend to stabilize or downgrade after PAE.
• Radiopathological correlation is necessary to validate PI-RADS scoring reliability post-PAE.
• PAE does not imply a cure for potential prostate cancer.