Evaluation of periprostatic neurovascular fibers before and after radical prostatectomy by means of 1.5 T MRI diffusion tensor imaging

Abstract

DTI was able to detect that the decrease of the number of the PNFs after RP was statistically related to the post-surgical erectile dysfunction (p < 0.05). Advances in knowledge: This work demonstrates that: (1) 1.5 T MRI DTI is able to detect the decrease of the number and of the FA of PNFs after prostatectomy; (2) the decrease of the number of PNFs after prostatectomy is related with the post-surgical erectile dysfunction; (3) 1.5 T MRI DTI has demonstrated to be a reproducible technique in detecting the changes of the PNFs induced by RP, with high interobserver agreement.

Basic concepts and applications of functional magnetic resonance imaging for radiotherapy of prostate cancer

“…For the prostate, DTI corresponds to the microstructural organization of the tissue and the cancer may change this structure [13] . DTI may also be used to visualize nerve bundles, which may be a tool although not yet clinically used to plan nerve sparing prostatic treatment and monitor post treatment nerve injury and reinnervation [28] . In the future, DTI may contribute to tumor detection or treatment follow-up.…”

Extended periprostatic nerve distributions on the prostate surface confirmed using diffusion tensor imaging

“…The investigations are interpreted using a Prostate Imaging Reporting and Data System (PI‐RADS) version 2, and PI‐RADS version 3 is in the development phase . Radiologists have previously performed different DTI investigations of the prostate, however, not with a urological surgeon's perspective . The expansion of MRI imaging using DTI can provide surgeons with the option to investigate a patient's individual nerve concordance on the prostate surface prior to surgery.…”

Evaluation of image‐based prognostic parameters of post‐prostatectomy urinary incontinence: A literature review

“…Change in MUL 27,30,35,43,61,[63][64][65] Change in MUA 61,64,65 Periurethral fibrosis 43,61,65 Number and length of PNF 45,46 Proximal urethral mobility [49][50][51] Funneling of the bladder neck on Valsalva [49][50][51] Urethral angle 49,50 Periurethral fibrosis 49 incontinent group, as well as a positive association between the perfusion ratio and the MUL. 29 DTI, a technique able to map and quantify peripheral nerve fibre distribution around the prostate, 44 has shown potential for detecting early decreases in peripheral nerves after RP; however, this relatively novel technique might prove to be more useful in predicting erectile dysfunction rather than PPUI.…”

“…43 More advanced MRI functional techniques, such as perfusion and diffusion, have been applied in the preoperative setting. Schimid et al measured the perfusion quality of the levator ani muscle compared with the surrounding pelvic muscle structures in 42 patients, and found a significantly higher perfusion ratio in levator ani muscle versus surrounding pelvic muscles in the continent group compared with the Prostatic volume 34,39,62 Pubic symphysis-PAL 61 Muscle perfusion 29 Apex type 41 Number and length of PNF 45,46…”

“…29 DTI, a technique able to map and quantify peripheral nerve fibre distribution around the prostate, 44 has shown potential for detecting early decreases in peripheral nerves after RP; however, this relatively novel technique might prove to be more useful in predicting erectile dysfunction rather than PPUI. 45,46…”