Predictors of Clinical Outcome after Prostate Artery Embolization with Spherical and Nonspherical Polyvinyl Alcohol Particles in Patients with Benign Prostatic Hyperplasia
| Autor: | Tiago Bilhim, Luís Campos Pinheiro, Lúcia Fernandes, Nuno Vasco Costa, José Pereira, Marisa Duarte, António G. Oliveira, João Pisco |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Gadolinium DTPA Male medicine.medical_specialty Pathology animal structures Urology Prostatic Hyperplasia Contrast Media 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Prostate medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test Proportional hazards model Urinary retention business.industry Hazard ratio Angiography Digital Subtraction Retrospective cohort study Magnetic resonance imaging Middle Aged Prostate-Specific Antigen Prognosis Embolization Therapeutic Magnetic Resonance Imaging Prostatic artery embolization medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Polyvinyl Alcohol International Prostate Symptom Score medicine.symptom business |
| Zdroj: | Radiology. 281(1) |
| ISSN: | 1527-1315 |
| Popis: | Purpose To assess predictors of outcome after prostate artery embolization (PAE) for benign prostatic hyperplasia with spherical particle polyvinyl alcohol (sPVA) and compare outcomes with the use of nonspherical particle polyvinyl alcohol (nsPVA). Materials and Methods This was a single-center retrospective institutional review board-approved study conducted from 2009 to 2015 in patients undergoing PAE with sPVA (n = 186; mean age ± standard deviation, 65.5 years ± 7.7) and nsPVA (n = 300; mean age, 65.3 years ± 7.6). The two cohorts were compared and analyzed for predictors of outcome with a Cox proportional hazards model and linear regression. Post-PAE prostate ischemia was measured with contrast material-enhanced magnetic resonance (MR) imaging in 23 patients with nsPVA and 25 patients with sPVA. The 24-hour post-PAE prostate-specific antigen (PSA) level was registered in 133 patients with sPVA. Prognostic values of MR imaging and PSA levels 24 hours after PAE were assessed with Cox and random-effects regressions. Results Predictors of clinical failure were older age (age over 65 years, P = .002), unilateral procedure (P = .002), and higher baseline International Prostate Symptom Score (IPSS, P = .033). Adjusted hazard ratio for clinical failure of sPVA was 1.273 (P = .16). Acute urinary retention was a predictor of lower IPSS after PAE (P = .002). The mean proportion of prostate ischemia was 11% with sPVA and 10% with nsPVA (P = .65). Lower IPSS after PAE was associated with a higher proportion of prostate ischemia (P = .009). Patients with a PSA level of at least 75 ng/mL (75 μg/L) 24 hours after PAE had a greater decrease in IPSS (P = .01). Prostate ischemic volume and PSA level 24 hours after PAE were correlated (Pearson r = 0.64, P = .014). Conclusion Clinical outcome was similar after PAE with sPVA and nsPVA. Younger age (up to 65 years), bilateral PAE, lower baseline IPSS, and acute urinary retention were predictors of better clinical outcome. The PSA level 24 hours after PAE correlated with prostate ischemia, and both correlated with clinical outcome. (©) RSNA, 2016. |
| Databáze: | OpenAIRE |
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