2044 DIFFUSION TENSOR MAGNETIC RESONANCE TRACTOGRAPHY OF THE PROSTATE: FEASIBILITY FOR NEUROANATOMIC MAPPING (2012)

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 20122044 DIFFUSION TENSOR MAGNETIC RESONANCE TRACTOGRAPHY OF THE PROSTATE: FEASIBILITY FOR NEUROANATOMIC MAPPING David S. Finley, Benjamin Ellingson, Shyam Natarajan, Taryar Zaw, Steven Raman, Peter Schulam, Robert Reiter, and Daniel Margolis David S. FinleyDavid S. Finley Los Angeles, CA , Benjamin EllingsonBenjamin Ellingson Los Angeles, CA , Shyam NatarajanShyam Natarajan Los Angeles, CA , Taryar ZawTaryar Zaw Los Angeles, CA , Steven RamanSteven Raman Los Angeles, CA , Peter SchulamPeter Schulam Los Angeles, CA , Robert ReiterRobert Reiter Los Angeles, CA , and Daniel MargolisDaniel Margolis Los Angeles, CA View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2208AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Present knowledge of periprostatic neuroanatomy is based largely on gross dissection of the prostate gland. We evaluated the feasibility of in-vivo diffusion tensor magnetic resonance imaging (DTI) tractography of the prostate to visualize and map periprostatic neurovascular anatomy. METHODS Eight men scheduled to undergo robot-assisted radical prostatectomy underwent 3.0Tesla endorectal multiparametric magnetic resonance imaging (MRI) of the prostate with DTI. Tract mapping was accomplished by positioning spherical regions of interest (ROI), with a radius of 1.5 mm contiguously along the prostatic capsule on axial T2W images at standardized locations at the prostatic apex, mid-gland, and base. Image processing was performed using the Diffusion Toolkit version 0.6.1 and TrackVis version (5.1, TrackVis.org, Mass General). Fiber tracts were constructed for each patient using an angle threshold of 35° and a Tensorline propagation algorithm with bootstrapping from multiple directions and averages. RESULTS DTI tractography was successfully performed in all eight patients, visualizing fiber tracts around the prostate. A dense network of fibers was identified around the entire border in the region between the prostatic capsule and lateral prostatic fascia (Figure 1A). Variation in total tract number (range: 709-2855, SD=875) was observed between patients and regions of the prostate (Figure 1B). Posterolateral fiber bundle mass varied between the right and left sides within individual patients (range 25.5%-74.5%). The total tract mass, corrected for prostate volume, was significantly larger for the lower prostate hemisphere compared with the upper hemisphere at the prostatic base (Fig 1C). The postero-lateral sectors, representing the putative "classic" region of the dominant NVB, accounted for only 32.3% of the total tract mass. Fiber tracts were seen crossing-over from the right and left sides of the prostate. CONCLUSIONS DTI tractography of the prostate effectively visualized periprostatic fiber tract anatomy. Variation in tract distribution and fiber cross-over was observed. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e824-e825 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information David S. Finley Los Angeles, CA More articles by this author Benjamin Ellingson Los Angeles, CA More articles by this author Shyam Natarajan Los Angeles, CA More articles by this author Taryar Zaw Los Angeles, CA More articles by this author Steven Raman Los Angeles, CA More articles by this author Peter Schulam Los Angeles, CA More articles by this author Robert Reiter Los Angeles, CA More articles by this author Daniel Margolis Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...