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• W4315631738 abstract "No AccessJournal of UrologyAdult Urology1 Apr 2023Impact of Prostate Urethral Lift Device on Prostate Magnetic Resonance Image QualityThis article is commented on by the following:Editorial Comment Tarik Benidir, Ethan Austhof, Ryan D. Ward, Justin Ream, Jenifer Bullen, Baris Turkbey, Peter A. Pinto, Francesco Giganti, Eric A. Klein, and Andrei S. Purysko Tarik BenidirTarik Benidir *Correspondence: Department of Urology, Cleveland Clinic–Glickman Urological and Kidney Institute, 9500 Euclid Blvd/Q10, Cleveland, OH 44195 telephone: 216-444-5600; E-mail Address: [email protected] https://orcid.org/0000-0003-2043-3658 Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , Ethan AusthofEthan Austhof Case Western Reserve University School of Medicine, Cleveland, Ohio More articles by this author , Ryan D. WardRyan D. Ward Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , Justin ReamJustin Ream https://orcid.org/0000-0003-1223-9054 Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , Jenifer BullenJenifer Bullen https://orcid.org/0000-0002-5403-2935 Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio More articles by this author , Baris TurkbeyBaris Turkbey https://orcid.org/0000-0003-0853-6494 Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland More articles by this author , Peter A. PintoPeter A. Pinto https://orcid.org/0000-0002-6399-7691 Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland More articles by this author , Francesco GigantiFrancesco Giganti https://orcid.org/0000-0001-5218-6431 Department of Radiology, University College London Hospital NHS Foundation Trust, London, United Kingdom Division of Surgery & Interventional Science, University College London, London, United Kingdom More articles by this author , Eric A. KleinEric A. Klein https://orcid.org/0000-0002-4467-4301 Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author , and Andrei S. PuryskoAndrei S. Purysko https://orcid.org/0000-0002-6888-0417 Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003156AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Prostatic urethral lift with UroLift is a minimally invasive approach to treat symptomatic benign prostatic hypertrophy. This device causes artifacts on prostate magnetic resonance images. Our aim was to evaluate the impact of artifact on prostate magnetic resonance image quality. Materials and Methods: This was a single-center retrospective review of patients with UroLift who subsequently had prostate magnetic resonance imaging. Two readers graded UroLift artifact on each pulse sequence using a 5-point scale (1—nondiagnostic; 5—no artifact). Prostate Imaging Quality scores were assigned for the whole data set. The volume of gland obscured by artifact was measured. Linear and logistic regression models were used to identify predictors of poor image quality. Results: Thirty-seven 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 vs T2-weighted and dynamic contrast-enhanced sequences (27%, 0.3%, 0%, respectively; P < .001). Suboptimal image quality (ie, Prostate Imaging Quality score ≤2) was found in 16%-24% of exams. The percentage of gland obscured by the UroLift artifact was higher on diffusion-weighted images and dynamic contrast-enhanced sequences than T2-weighted (32%, 9%, and 6%, respectively; P < .001). Conclusions: UroLift artifact negatively affects prostate magnetic resonance image quality with greater impact in the mid-basal transition zone, obscuring a third of the gland on diffusion-weighted images. 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. REFERENCES 1. . Emerging minimally invasive treatment options for male lower urinary tract symptoms. Eur Urol. 2017; 72(6):986-997. Crossref, Medline, Google Scholar 2. . Five year results of the prospective randomized controlled prostatic urethral L.I.F.T. study. Can J Urol. 2017; 24(3):8802-8813. Medline, Google Scholar 3. . Prostatic urethral lift vs transurethral resection of the prostate: 2-year results of the BPH6 prospective, multicentre, randomized study. BJU Int. 2017; 119(5):767-775. Crossref, Medline, Google Scholar 4. . Mini-review: what is new in Urolift?. Eur Urol Focus. 2018; 4(1):36-39. 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Crossref, Medline, Google Scholar 22. . Utility of ADC measurement on diffusion-weighted MRI in differentiation of prostate cancer, normal prostate and prostatitis. Quant Imaging Med Surg. 2013; 3(4):210-216. Medline, Google Scholar 23. . The UroLift system: a progress report. Trends Urol Men Health. 2020; 11(2):13-17. Crossref, Google Scholar Support: None. Conflict of Interest: ASP: Koelis, Blue Earth Diagnostics, Profound Medical. Ethics Statement: This study received Institutional Review Board approval (IRB No. 20-103). Author Contributions: Conception and design: TB, BT, PAP, FG, ASP; data analysis and interpretation: TB, JB, BT, PAP, FG, EAK, ASP; data acquisition: EA, RDW, JR, BT, ASP; critical revision of the manuscript for scientific and factual content: EA, RDW, JR, BT, PAP, FG, EAK, ASP; drafting the manuscript: TB, EA, JB, BT, ASP; statistical analysis: TB, JB, BT, ASP; supervision: TB, EA, RDW, JR, BT, PAP, FG, EAK, ASP. Editor's Note: This article is the fourth of 5 published in this issue for which Category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 816 and 817. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byRegmi S (2023) Editorial CommentJournal of Urology, VOL. 209, NO. 4, (761-761), Online publication date: 1-Apr-2023.Related articlesJournal of Urology26 Jan 2023Editorial Comment Volume 209Issue 4April 2023Page: 752-761Supplementary Materials Peer Review Report Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsMetricsAuthor Information Tarik Benidir Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio *Correspondence: Department of Urology, Cleveland Clinic–Glickman Urological and Kidney Institute, 9500 Euclid Blvd/Q10, Cleveland, OH 44195 telephone: 216-444-5600; E-mail Address: [email protected] More articles by this author Ethan Austhof Case Western Reserve University School of Medicine, Cleveland, Ohio More articles by this author Ryan D. Ward Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Justin Ream Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Jenifer Bullen Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio More articles by this author Baris Turkbey Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland More articles by this author Peter A. Pinto Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland More articles by this author Francesco Giganti Department of Radiology, University College London Hospital NHS Foundation Trust, London, United Kingdom Division of Surgery & Interventional Science, University College London, London, United Kingdom More articles by this author Eric A. Klein Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Andrei S. Purysko Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Expand All Support: None. Conflict of Interest: ASP: Koelis, Blue Earth Diagnostics, Profound Medical. Ethics Statement: This study received Institutional Review Board approval (IRB No. 20-103). Author Contributions: Conception and design: TB, BT, PAP, FG, ASP; data analysis and interpretation: TB, JB, BT, PAP, FG, EAK, ASP; data acquisition: EA, RDW, JR, BT, ASP; critical revision of the manuscript for scientific and factual content: EA, RDW, JR, BT, PAP, FG, EAK, ASP; drafting the manuscript: TB, EA, JB, BT, ASP; statistical analysis: TB, JB, BT, ASP; supervision: TB, EA, RDW, JR, BT, PAP, FG, EAK, ASP. Editor's Note: This article is the fourth of 5 published in this issue for which Category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 816 and 817. Advertisement PDF downloadLoading ..." @default.
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