Contrast-Enhanced Ultrasonography for the Early Evaluation of Prostate Artery Embolization.

AIM: To prospectively evaluate the feasibility and reproducibility of the semiquantitative measurement of the unenhanced area of the prostate by trans-abdominal contrast-enhanced ultrasound (CEUS) performed immediately after prostate artery embolization (PAE) as a prognostic factor of success. METHODS: Thirty-nine patients with PAE were prospectively included. They all underwent pre- and post-PAE trans-abdominal prostate CEUS. Two readers independently evaluated the pre- and post-PAE unenhanced area using a semiquantitative method: unenhanced areas were measured on 3 different slices (basis, middle, and apex) and reported to the whole prostate area. The mean of the three measures was reported semiquantitatively in classes of ten percent and quartiles. We evaluated correlation with clinical success, at 3 months after PAE, defined as a > 25% reduction in the International Prostatic Symptoms Score and a Quality of life   25%. The semiquantitative measurement was found to be highly reproducible, with an interclass correlation > 0.8. No correlation was found between the area of unenhanced tissue and clinical success evaluated at 3 months. CONCLUSION: Trans-abdominal prostate CEUS performed early after PAE provides reproducible results and is a valuable tool to evaluate unenhanced areas of the prostate. LEVEL OF EVIDENCE: 3, local non random sample.