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A correlation study between prostate necrosis rate calculated by 3D Slicer software and clinical efficacy of prostatic artery embolization, along with an analysis of predictors of clinical success after prostatic artery embolization

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the correlation between the prostate necrosis rate at 1-month after prostatic artery embolization (PAE) and the clinical efficacy at 1-year after PAE, and to explore potential predictors of clinical success after PAE for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH).

Methods

The prostate magnetic resonance imaging data at 1-month after PAE were imported into 3D Slicer software for calculating the prostate necrosis rate and thus analyzing the relationship between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after PAE. The 151 patients with PAE technical success were divided into a clinical success group (n = 126) and a clinical failure group (n = 25). Independent predictors of clinical success after PAE were analyzed by multifactorial logistic regression, and the predictive performance of each factor was evaluated by applying the receiver operating characteristic curve and the area under the curve (AUC).

Results

There was a linear negative correlation between the prostate necrosis rate at 1-month after PAE and the efficacy score ratio at 1-year after surgery (P < 0.001). In the clinical success group, both the initial prostate volume (PV) and the prostate necrosis rate at 1-month after PAE were significantly higher than in the clinical failure group (P < 0.001), and acute urinary retention (AUR) and adenomatous-dominant BPH were also associated with clinical success (P < 0.05). Multifactorial logistic regression analysis revealed that larger initial PV, a higher prostate necrosis rate at 1-month after surgery, and AUR were independent predictors of clinical success after PAE. The AUC values for these three indicators and their combination were 0.720, 0.928, 0.599, and 0.951, respectively, in which the prostate necrosis rate at 1-month after PAE demonstrating a high predictive value.

Conclusion

The higher the prostate necrosis rate at 1-month after PAE, the better the clinical efficacy at 1-year after PAE is likely to be, and the prostate necrosis rate at 1-month after PAE is expected to become a predictor of clinical success after PAE.

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Data availability

Data supporting the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

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Funding

This work was supported by the Fujian Province Natural Science Fund Project (2021J02053, 2022J01996, 2020J011064, 2020J011096), the Special Research Foundation of Fujian Provincial Department of Finance (2020-822, 2021-848, 2021-917, 2022-840), National famous and old Chinese medicine experts (Xuemei Zhang, Xiaohua Yan) inheritance studio construction project, and the Fujian Province Medical Innovation Foundation (2021CXB001, 2022CXB002, 2022CXA001).

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Author notes

  1. Ruo‑li Wang, Fang-fang Lin, and Dan‑dan Ruan have contributed equally to this work.

Authors and Affiliations

  1. Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China

    Ruo‑li Wang, Fang-fang Lin, Dan‑dan Ruan, Shi-jie Li, Yan‑feng Zhou, Jie‑wei Luo, Zhu‑ting Fang & Yi Tang

  2. Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou, 350001, China

    Ruo‑li Wang

  3. Radiology Department, Fujian Provincial Hospital, Fuzhou, 350001, China

    Fang-fang Lin

  4. Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, 350001, China

    Yan‑feng Zhou, Zhu‑ting Fang & Yi Tang

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Contributions

YT, ZTF, and JWL conceived and designed the study. YT and FFL collected the data. SJL and YFZ conducted the data analysis and interpretation. RLW, FFL, and DDR wrote the manuscript. YT and ZTF made critical revisions to the important contents of the manuscript.

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Correspondence to Jie‑wei Luo, Zhu‑ting Fang or Yi Tang.

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All procedures were performed in accordance with the tenets of the Declaration of Helsinki and the study was approved by the Ethics Committee of Fujian Provincial Hospital.

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Wang, R., Lin, Ff., Ruan, D. et al. A correlation study between prostate necrosis rate calculated by 3D Slicer software and clinical efficacy of prostatic artery embolization, along with an analysis of predictors of clinical success after prostatic artery embolization. Abdom Radiol 49, 927–938 (2024). https://doi.org/10.1007/s00261-023-04131-5

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