Role of mpMRI in Benign Prostatic Hyperplasia Assessment and Treatment
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BENIGN PROSTATIC HYPERPLASIA (K MCVARY, SECTION EDITOR)
Role of mpMRI in Benign Prostatic Hyperplasia Assessment and Treatment Stephanie M. Walker 1 & Baris Turkbey 1 Accepted: 15 October 2020 # This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract Purpose of Review To summarize the role of prostate MRI in the assessment and treatment of benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS). Recent Findings BPH/LUTS is a very common source of morbidity in aging men. mpMRI has become an increasingly popular modality for prostate imaging due to its ability to provide exceptional anatomic detail. This has allowed for MRI classification of BPH and detailed assessment of response to various BPH treatment modalities, including simple prostatectomy and transurethral resection of the prostate as well as newer methods like UroLift and prostatic artery embolization. Summary MRI will continue to be a useful tool in the diagnosis and management of BPH/LUTS and provides useful information about the efficacy of a variety of available treatment options. Further studies are needed to fully characterize the effects of newer BPH interventions on mpMRI. Keywords Benign prostatic hyperplasia . BPH . mpMRI . Prostate MRI . Urinary incontinence . LUTS
Introduction Benign prostatic hyperplasia (BPH) is a highly prevalent condition in aging individuals, with 80% developing BPH in their lifetime and as many as 30% receiving treatment [1]. While many men with BPH will never see a doctor, it can be a major cause of morbidity in those who develop symptoms [2]. Symptoms of BPH result from urethral compression by hyperplasia of prostatic stromal and epithelial cells. This results in what are collectively referred to as lower urinary tract symptoms (LUTS): voiding difficulties, bladder storage problems, urinary urgency and frequency, weak urinary stream, nocturia, and urinary leakage [3]. With life expectancy increasing, so too will the incidence and progression rates of BPH and associated LUTS [4]. Medical therapies (alpha blockers and 5-alpha-reductase inhibitors) will be less likely to demonstrate a clinical response, and This article is part of the Topical Collection on Benign Prostatic Hyperplasia * Baris Turkbey [email protected] 1
Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, Room B3B85, MD 20892 Bethesda, USA
more patients will turn to surgical and minimally invasive interventions to manage symptoms [5]. With recent technologic advancements and rise in popularity of prostate MRI, the anatomy of the prostate can be seen in great detail. MRI can be used to both characterize BPH and assess response to treatment [6–8]. Additionally, lobar classification on MRI has the potential to direct treatment decisions for BPH. mpMRI of the prostate has also become increasingly common for prostate cancer detection and surveillance due to its ability to guide targeted biopsies and foca
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