Markus F Muller MD, Presenter: Nothing to Disclose

Stepan Vesely MD, Abstract Co-Author: Nothing to Disclose

Jacqueline Nel, Abstract Co-Author: Nothing to Disclose

Susanne Ribbelin, Abstract Co-Author: Nothing to Disclose

Christer Dahlstrand MD, PhD, Abstract Co-Author: Nothing to Disclose

to assess morphological and structural features of the hyperplastic prostate with MRI before and after TUMT and to determine their influence on the treatment and to identify specific parameters able to predict favorable therapeutic response

11 patients with chronic urinary retention due to BPH were included. Coretherm (ProstaLund, Lund, S) TUMT was performed with the set goal to create a 30% necrosis of the prostate. The patients were examined with a 1.5-T MRI before, 1 week, and 6 months after TUMT using a 5-element phased array coil and the following sequences: sagittal T2-w. TSE, sagittal T2-w. TSE for T2 calculation, transverse T2-diffusionw. SE-EPI with 5 b-factors, and sagittal dynamic 3D T1-w. FFE sequences before and under intravenous gadolinium bolus injection (0.2 mmol gadolinium/kg body weight).

Mean values of T2, ADC and mean upslope of the prostate before TUMT were 111.9±21.0 ms, 1.76±0.27x10-3 mm2/s, and 34.7±10.2, respectively. The T2-value of the prostate before TUMT correlated significantly with the prostate volume and the perfusion defect after TUMT, but not with the applied energy, duration, or mean effect under the TUMT. The ADC before TUMT correlated significantly with prostate volume, applied energy, duration, and mean effect during TUMT, but not with the perfusion defect after TUMT. The mean upslope of the prostate perfusion showed no significant correlation with neither prostate volume, energy, duration, mean effect of the TUMT nor posttherapeutic perfusion defect. The under the TUMT calculated cell-kill (73.1±7.5g) corresponded to 29% of the prostate volume and correlated significantly with the resulted perfusion defect (23.6±12.6cm3). 6 months after TUMT patients were able to void spontaneously and had a cavity in the prostate with a volume of 7.6±7.1cm3.

Coretherm TUMT seems to be an effective therapy in chronic urinary retention due to BPH which leads to intraprostatic necrosis, detectable with MRI even 6 months after the treatment. Our preliminary results suggest that T2- and diffusion-w. MRI may be used to characterize the prostate and predict the response of the prostate during and after thermotherapy.

to assess morphological and structural features of the hyperplastic prostate with MRI before and after TUMT and to determine their influence on the treatment and to identify specific parameters able to predict favorable therapeutic response

11 patients with chronic urinary retention due to BPH were included. Coretherm (ProstaLund, Lund, S) TUMT was performed with the set goal to create a 30% necrosis of the prostate. The patients were examined with a 1.5-T MRI before, 1 week, and 6 months after TUMT using a 5-element phased array coil and the following sequences: sagittal T2-w. TSE, sagittal T2-w. TSE for T2 calculation, transverse T2-diffusionw. SE-EPI with 5 b-factors, and sagittal dynamic 3D T1-w. FFE sequences before and under intravenous gadolinium bolus injection (0.2 mmol gadolinium/kg body weight).

Mean values of T2, ADC and mean upslope of the prostate before TUMT were 111.9±21.0 ms, 1.76±0.27x10-3 mm2/s, and 34.7±10.2, respectively. The T2-value of the prostate before TUMT correlated significantly with the prostate volume and the perfusion defect after TUMT, but not with the applied energy, duration, or mean effect under the TUMT. The ADC before TUMT correlated significantly with prostate volume, applied energy, duration, and mean effect during TUMT, but not with the perfusion defect after TUMT. The mean upslope of the prostate perfusion showed no significant correlation with neither prostate volume, energy, duration, mean effect of the TUMT nor posttherapeutic perfusion defect. The under the TUMT calculated cell-kill (73.1±7.5g) corresponded to 29% of the prostate volume and correlated significantly with the resulted perfusion defect (23.6±12.6cm3). 6 months after TUMT patients were able to void spontaneously and had a cavity in the prostate with a volume of 7.6±7.1cm3.

Coretherm TUMT seems to be an effective therapy in chronic urinary retention due to BPH which leads to intraprostatic necrosis, detectable with MRI even 6 months after the treatment. Our preliminary results suggest that T2- and diffusion-w. MRI may be used to characterize the prostate and predict the response of the prostate during and after thermotherapy.

Muller, M, Vesely, S, Nel, J, Ribbelin, S, Dahlstrand, C, MR Imaging in the Evaluation of Transurethral Microwave Thermotherapy (TUMT) Treatment of Benign Hyperplasia of the Prostate (BHP).  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4413414.html