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ORLANDO, FL USA ( - Diffusion tensor imaging (DTI) and tractography are used to obtain information about the neural tissue in the brain. DTI has also recently been used to obtain information about the peri-prostatic nerves. However, there have been no studies assessing the changes in these nerves when using DTI before and after radical prostatectomy. Hideaki Miyake and colleagues sought to evaluate these changes using DTI and tractography.

auaThe authors used DTI with tractography on 52 patients before and after radical prostatectomy. This technology was used to the track the nerve bundles and assess changes prior to and following radical prostatectomy. Both nerve sparing and non-nerve sparing strategies were employed.

In the prostatic sectors from non-nerve sparing procedures, the number of nerve tracts at the base and apex were significantly lower (P < 0.0001). In prostatic sectors from nerve-sparing procedures, the numbers of nerve tracts were not different between pre and post prostatectomy.

The authors concluded that DTI with tractography might be a feasible technique to assist in the visualization of nerve tracts during radical prostatectomy, regardless of whether nerve-sparing or non-nerve sparing strategy is employed. The benefits of this visualization can be tremendous, especially for performing accurate prostatectomies where an assessment and protection of nerve bundles around the prostate is a necessity.

Future studies should evaluate the potential for this imaging technique to predict nerve damage leading to impotence and incontinence after prostatectomies as these pathologies have great clinical implications.

Presented by Hideaki Miyake, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA

Kobe, Japan

Written by Garen Abedi, MD, University of California (Irvine), and medical writer for


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