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Impact of Prostate Urethral Lift Device on Prostate MR Image Quality

Benidir, Tarik; Austhof, Ethan; Ward, Ryan D; Ream, Justin; Bullen, Jenifer; Turkbey, Baris; Pinto, Peter A; ... Purysko, Andrei S; + view all (2023) Impact of Prostate Urethral Lift Device on Prostate MR Image Quality. The Journal of Urology , 209 (4) pp. 752-761. 10.1097/JU.0000000000003156. Green open access

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Abstract

INTRODUCTION: Prostatic urethral lift with UroLift® is a minimally invasive approach to treat symptomatic benign prostatic hypertrophy. This device causes artifacts on prostate MR images. Our aim was to evaluate the impact of artifact on prostate MR image quality. MATERIAL AND METHODS: Single-center, retrospective review of patients with UroLift® who subsequently had prostate MRI. Two readers graded UroLift® artifact on each pulse sequence using a 5-point scale (1. Non-diagnostic; 5. No artifact). Prostate Imaging Quality scores were assigned for the whole dataset. The volume of gland obscured by artifact was measured. Linear and logistic regression models were used to identify predictors of poor image quality. RESULTS: 37 patients were included. Poor image quality occurs more in the transition zone than the peripheral zone (15% vs 3%), at base/mid regions vs the apex (13%, 9% and 5%, respectively) and on diffusion-weighted images (DWI) vs T2-weighted (T2WI) and dynamic contrast-enhanced (DCE) sequences (27%, 0.3%, 0%, respectively) (p < 0.001). Suboptimal image quality (i.e., PI-QUAL score < 2) was found in 16-24% of exams. The percentage of gland obscured by the UroLift® artifact was higher on DWI and DCE sequences than T2WI (32%, 9%, and 6%, respectively;p<0.001). CONCLUSION: UroLift® artifact negatively affects prostate MR image quality with greater impact in the mid-basal transition zone, obscuring a third of the gland on DWI. Patients considering this procedure should be counseled on the impact of this device on image quality and its potential implications for any image-guided prostate cancer workup.

Type: Article
Title: Impact of Prostate Urethral Lift Device on Prostate MR Image Quality
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/JU.0000000000003156
Publisher version: https://doi.org/10.1097/JU.0000000000003156
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Prostate cancer, Urolift, prostate MRI
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
URI: https://discovery.ucl.ac.uk/id/eprint/10163696
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