Can Computed Tomography Perfusion Predict Treatment Response After Prostate Artery Embolization: A Feasibility Study

Abstract

Prostate artery embolization (PAE) is an emerging therapy for benign prostatic hyperplasia (BPH). Optimal patient selection is an important step when introducing new treatments and several characteristics associated with a good clinical outcome has previously been proposed. However, no prognostic tool is yet available for PAE. Computed tomography perfusion is an imaging technique that provides hemodynamic parameters making it possible to estimate the prostatic blood flow (PBF). This study investigated the relationship between PBF and the response to PAE. A post hoc analysis including prostate-specific antigen (PSA) measurements before and 24-h after embolization from two prospective studies on sixteen patients undergoing PAE with BPH or prostate cancer were performed. The primary outcome was the correlation between baseline PBF and the change in PSA as a surrogate measure of treatment response. Prostate volume strongly correlated with treatment response and the response was greater with incremental amounts of injected embolic material. PBF was not associated with elevation in PSA and added no information that could guide patient selection.

New Trends in Vascular Imaging

“…The method has become an established technique for stroke assessment in most centers, but has also been applied to cardiology, and to a lesser extent for abdominal imaging. In this special edition, CT perfusion was used for treatment evaluation after prostate artery embolization in patients with benign prostatic hyperplasia [ 7 ].…”

“…In this special edition both case series, original research, and reviews are presented. The topics cover various vascular geometries using ultrasound, CT, MRI, and angiography [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”