Association Between Penile Dynamic Contrast-Enhanced MRI-Derived Quantitative Parameters and Self-Reported Sexual Function in Patients with Newly Diagnosed Prostate Cancer

Abstract

Introduction The high incidence of prostate cancer, coupled with excellent prostate cancer control rates, has resulted in growing interest in nononcological survivorship issues such as sexual function. Multiparametric magnetic resonance imaging (MRI) is increasingly being performed for local staging of prostate cancer, and due to the close anatomical relationship to the prostate, penile enhancement is often depicted in prostate MRI. Aim To evaluate the associations between quantitative perfusion-related parameters derived from dynamic contrast-enhanced (DCE)-MRI of the penis and self-reported sexual function in patients with newly diagnosed prostate cancer. Methods This retrospective study included 50 patients who underwent DCE-MRI for prostate cancer staging before prostatectomy. The following perfusion-related parameters were calculated: volume transfer constant (Ktrans), rate constant (kep), extracellular-extravascular volume fraction (ve), contrast enhancement ratio (CER), area under the gadolinium curve after 180 seconds (AUC180), and slope of the time/signal intensity curve of the corpora cavernosa. Associations between perfusion-related parameters and self-reported sexual function were evaluated using the Wilcoxon Rank-Sum test. Main Outcome Measures Patient responses to the sexual function domain of the Prostate Quality of Life survey. Results Five of the six DCE-MRI parameters (Ktrans, ve, CER, AUC180, and slope) were significantly associated with the overall score from the sexual domain of the survey (P = 0.0020–0.0252). CER, AUC180, and slope were significantly associated with the answers to all six questions (P = 0.0020–0.0483), ve was significantly associated with the answers to five of six questions (P = 0.0036–0.1029), and Ktrans was significantly associated with the answers to three of six questions (P = 0.0252–0.1023). kep was not significantly associated with the overall survey score (P = 0.7665) or the answers to any individual questions (P = 0.4885–0.8073). Conclusion Penile DCE-MRI parameters were significantly associated with self-reported sexual function in patients with prostate cancer. These parameters are readily available when performing prostate MRI for staging and may be relevant to the management of patients considering prostate cancer therapies.

Evaluation of young men with organic erectile dysfunction

“…Vargas et al . 27 evaluated 50 prostate cancer patients who underwent an MRI pelvis for staging prior to prostatectomy. They found a correlation between a patient's self-reported sexual function and perfusion-related parameters noted on MRI.…”

Dynamic contrast enhancement in prostate MRI as predictor of erectile function and recovery after radical prostatectomy

“…Periprostatic fascia thickness measured by preoperative 3 T MRI was further identified as correlating positively with postoperative EF [37]. In a paper from Vargas et al, dynamic CE MRI from the corpora cavernosa of the penis was used to derive quantitative perfusion-related parameters in patients with newly diagnosed PCa and was correlated to self-reported sexual function [38] -however, only the preoperative status of EF was assessed.…”