Sant'Andrea Hospital, University LA SAPIENZA, Rome, IT
Introduction: Magnetic Resonance Imaging (MRI) of the prostate has gained popularity in the field of prostate cancer management. Little is known about the use of MRI in the management of lower urinary tract symptoms (LUTS). Aim of the study was to assess whether prostate features on MRI can be related to LUTS. Methods: Patients who underwent MRI for clinical suspicion of PCA were evaluated for LUTS through International Prostatic Symptoms Score (IPSS) and uroflowmetry. Prostate Volume (PV), Detrusor Wall Thickness (DWT) and Intravesical Prostatic Protrusion (IPP) were measured respectively by using conventional prolate ellipsoid formula, as the mean of thickness of the anterior-posterior and dome bladder walls, as the vertical distance from the tip of the protruding prostate to the base of the bladder. Prostate shape was classified in accordance to previously reported classification of Randal as follows: type 0, an equal to or less than 25 cm3 prostate showing little or no zonal enlargement; type 1, bilateral TZ enlargement; type 2, retrourethral enlargement; type 3, bilateral TZ and retrourethral enlargement; type 4, solitary or multiple pedunculated enlargement; type 5, pedunculated with bilateral TZ and/or retrourethral enlargement; type 6, subtrigonal or ectopic enlargement; and type 7, other combinations of enlargements Pearson correlation coefficient was computed to text the association between MRI features and IPSS and Qmax (pearson 0.65 p=0.001). Results: 38 mpMRI were reviewed by urology-dedicated radiologist. Mean age of patients was 61.9 ± 25.2 years. Mean DWT, prostate volume, IPP, IPSS, and Qmax were respectively 3.8±2.05mm, 64.16±31.6mm3, 4.5±0.5mm, 20.13±7.08 points, 15.09±5.35 ml/sec. Regarding prostate shape, Randall type 0, type 1, type 2, type 3, type 4, type 5 were found respectively in 3(7.9%), 6(15.8%), 5(13.2%), 12(31.6%),4 (10.5%),8 (21.1%) patients. Interesting, prostate volume, IPP, and prostate shape were significantly correlated to IPSS while only IPP and prostate shape were correlated to Qmax (table 1). LUTS_IPSS Qmax ? ? Prostate Volume 0.70* -0.23 DWT 0.22 0.26 IPP 0.56* -0.35* Randal shape type 0.65* -0.54* *p < 0.05 Conclusions: Our preliminary data suggest that MRI prostate features may be used as tool to assess the main outcomes related to LUTS, i.e. IPSS and Qmax. Of course, further studies are still required to introduce MRI in the field of LUTS-BPH. SOURCE OF Funding: No one
