MRI-based measurements can predict urinary continence after prostate surgery
MRI-based anatomical measurements gathered before radical prostatectomy can help radiologists predict whether a patient will experience postoperative urinary incontinence.
Urinary continence is an important factor in a patient's quality of life. Men with prostate cancer who have undergone radical prostatectomy (RP) are at an increased risk of developing incontinence after surgery, with some research suggesting that only 35% of men who undergo RP have full urinary control 12 months after the procedure.
“The ability to predict continence after RP could substantially aid physicians and patients when making treatment recommendations or decisions,” corresponding author Hannah Lamberg, with the Department of Radiology at the University of Michigan, and co-authors explained.
Although previous studies have pointed to membranous urethra length (MUL) as a predictor of postoperative urinary incontinence, the interrater agreement in those studies varied widely between radiologists. This is what led researchers at the University of Michigan to examine the clinical significance of MRI-based anatomic measurements in conjunction with interrater agreement of said measurements.
The study utilized preoperative MRI-based measurements assessed by four abdominal radiologists with training specific to this area of reserach. Using the measurements of 586 men who underwent RP, the radiologists predicted continence at 3, 6 and 12 months postoperatively.
Before surgery, only 0.2% of men experienced incontinence. That number increased to 27% at the three month mark, before consistently decreasing at six and 12 months down to 14% and 9%, respectively. At every time point, longer MULs coincided with increased continence.
In addition to longer MULs acting as an independent predictor of continence, the researcher also noted that the interrater agreement was better among the radiologists who underwent MRI-based measurement training compared to those who did not.
“Our findings support the use of coronal membranous urethra length in combination with clinical variables to predict post–radical prostatectomy urinary continence," the experts explained. "Our data also support the need for specific training of radiologists in performing MUL measurements to improve interrater agreement."
They went on to say that the development of a continence nomogram based on individual clinical data and MRI measurements could assist patients and providers in treatment decisions.
You can view the detailed research here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.