Abstracts

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E2218. Prostate MRI After Minimally Invasive Procedures: Complications and Normal Findings
Authors
  1. Thanh-Lan Bui; University of California - Irvine
  2. Justin Glavis-Bloom; University of California - Irvine
  3. Joseph Carbone; University of California - Irvine
  4. Mark Rupasinghe; University of California - Irvine
  5. Raj Mehta; University of California - Irvine
  6. Michelle Bardis; University of California - Irvine
  7. Roozbeh Houshyar; University of California - Irvine
Background
Recently, less invasive procedures for treating benign prostatic hyperplasia (BPH) and low-risk localized prostatic cancer in certain patients have gained popularity because they mitigate the risks of traditional prostatectomy, such as damage to the neurovascular bundle and urethra. Minimally invasive procedures for BPH include prostatic artery embolization and prostatic urethral lift. For indolent localized prostate cancer, they include irreversible electroporation, photodynamic therapy, high intensity focused ultrasound, focal cryotherapy, and focal laser ablation. Magnetic resonance imaging (MRI) is increasingly utilized to evaluate the prostate and has high specificity, sensitivity, and negative predictive value in detecting prostate cancer. Minimally invasive procedures can distort the appearance of the prostate and may introduce imaging artifacts, making prostate MRI interpretation challenging. As minimally invasive procedures and prostate MRI volumes continue to increase, radiologists must be familiar with the common procedures, complications, and expected post-procedure appearance of the prostate.

Educational Goals / Teaching Points
This exhibit aims to educate radiologists on contemporary procedures for BPH and localized prostate cancer in certain patients, common complications of these procedures, and expected post-procedure MRI findings. We hope to provide the radiology community with up-to-date imaging characteristics of the prostate after undergoing one of these novel procedures to ensure accurate interpretation when reading prostate MRI.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Prostate MRI is increasingly utilized to evaluate the prostate gland, for initial imaging and for follow-up after minimally invasive procedures treating BPH or low-risk localized prostate cancers. We provide a pictorial essay of common minimally invasive procedures highlighting the procedure steps, complications, and normal post-procedure findings, both immediate and at delayed follow-up.

Conclusion
Minimally invasive procedures can effectively treat BPH and localized prostate cancers in specific patients with fewer complications than traditional approaches such as prostatectomy. Radiologists reading prostate MRI should be familiar with these procedures and their associated complications and post-procedure imaging findings to ensure accurate interpretation.