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Marc L Kessler - One of the best experts on this subject based on the ideXlab platform.

  • vessel sparing prostate radiotherapy dose limitation to critical erectile vascular structures Internal Pudendal Artery and corpus cavernosum defined by mri
    International Journal of Radiation Oncology Biology Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore S Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.

  • Vessel-sparing prostate radiotherapy: dose limitation to critical erectile vascular structures (Internal Pudendal Artery and corpus cavernosum) defined by MRI.
    International Journal of Radiation Oncology*Biology*Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.

V V Anichkin - One of the best experts on this subject based on the ideXlab platform.

  • Transperineal ultrasound imaging of the Internal Pudendal Artery in arteriogenic erectile dysfunction
    Urologiia, 2017
    Co-Authors: E. A. Povelitsa, N I Dosta, O V Parhomenko, D M Nitkin, A M Shesternja, V V Anichkin
    Abstract:

    AIM To determine the practical and diagnostic value of transperineal ultrasound imaging of the Internal Pudendal Artery (IPA) in patients with arteriogenic erectile dysfunction (ED). MATERIALS AND METHODS Transperineal IPA and penile Doppler ultrasonography was performed in 50 healthy young male volunteers aged 23.6+/-3.4 years without ED (IIEF-5 score of 21-22) and 60 patients with ED (IIEF-5 score of 6-18, mean age 49+/-4.6 years), including 30 men with prostate cancer (PCa) after comprehensive treatment and 30 patients with type 1 and type 2 diabetes mellitus. To determine the diagnostic value of the transperineal IPA imaging, the results were compared with the findings of magnetic resonance or contrast-enhanced dynamic CT angiography of the iliac arteries. RESULTS In all healthy men no abnormalities were found in the perineal primary arterial blood flow, in 100% of cases perineal branch of IPA was rectilinear, while patients with arteriogenic ED had low IPA and penile peak systolic blood flow velocity (

  • transperineal ultrasound imaging of the Internal Pudendal Artery in arteriogenic erectile dysfunction
    Urologii︠a︡ (Russia), 2017
    Co-Authors: E. A. Povelitsa, N I Dosta, O V Parhomenko, D M Nitkin, A M Shesternja, V V Anichkin
    Abstract:

    AIM To determine the practical and diagnostic value of transperineal ultrasound imaging of the Internal Pudendal Artery (IPA) in patients with arteriogenic erectile dysfunction (ED). MATERIALS AND METHODS Transperineal IPA and penile Doppler ultrasonography was performed in 50 healthy young male volunteers aged 23.6+/-3.4 years without ED (IIEF-5 score of 21-22) and 60 patients with ED (IIEF-5 score of 6-18, mean age 49+/-4.6 years), including 30 men with prostate cancer (PCa) after comprehensive treatment and 30 patients with type 1 and type 2 diabetes mellitus. To determine the diagnostic value of the transperineal IPA imaging, the results were compared with the findings of magnetic resonance or contrast-enhanced dynamic CT angiography of the iliac arteries. RESULTS In all healthy men no abnormalities were found in the perineal primary arterial blood flow, in 100% of cases perineal branch of IPA was rectilinear, while patients with arteriogenic ED had low IPA and penile peak systolic blood flow velocity (<0.05), pathologically altered type of blood flow and non-rectilinear course of IPA, stenosis and occlusion in the pelvic and extrapelvic branches of IPA. When comparing the findings of IPA Doppler ultrasound and angiography studies of the small pelvis in healthy men, they completely matched, showing satisfactory arterial IPA perfusion, absence of stenoses or occlusions. Sensitivity and specificity of the transperineal IPA ultrasound imaging were 95% and 90%, respectively. CONCLUSION Transperineal IPA ultrasound imaging allows to assess the important morphometric features of the perineal branches of IPA - the arterial diameter, the response to stimulation, the course of the Artery, the type of arterial blood flow, the presence or absence of arterial stenoses and occlusions, and to measure peak systolic blood flow velocity.

Patrick W Mclaughlin - One of the best experts on this subject based on the ideXlab platform.

  • vessel sparing prostate radiotherapy dose limitation to critical erectile vascular structures Internal Pudendal Artery and corpus cavernosum defined by mri
    International Journal of Radiation Oncology Biology Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore S Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.

  • Vessel-sparing prostate radiotherapy: dose limitation to critical erectile vascular structures (Internal Pudendal Artery and corpus cavernosum) defined by MRI.
    International Journal of Radiation Oncology*Biology*Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.

Peter L Roberson - One of the best experts on this subject based on the ideXlab platform.

  • vessel sparing prostate radiotherapy dose limitation to critical erectile vascular structures Internal Pudendal Artery and corpus cavernosum defined by mri
    International Journal of Radiation Oncology Biology Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore S Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.

  • Vessel-sparing prostate radiotherapy: dose limitation to critical erectile vascular structures (Internal Pudendal Artery and corpus cavernosum) defined by MRI.
    International Journal of Radiation Oncology*Biology*Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.

Vrinda Narayana - One of the best experts on this subject based on the ideXlab platform.

  • vessel sparing prostate radiotherapy dose limitation to critical erectile vascular structures Internal Pudendal Artery and corpus cavernosum defined by mri
    International Journal of Radiation Oncology Biology Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore S Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.

  • Vessel-sparing prostate radiotherapy: dose limitation to critical erectile vascular structures (Internal Pudendal Artery and corpus cavernosum) defined by MRI.
    International Journal of Radiation Oncology*Biology*Physics, 2005
    Co-Authors: Patrick W Mclaughlin, Vrinda Narayana, Amichay Meirowitz, Sara Troyer, Peter L Roberson, Roger L Gonda, Howard M Sandler, Lon H Marsh, Theodore Lawrence, Marc L Kessler
    Abstract:

    Purpose: Most evidence suggests that impotence after prostate radiation therapy has a vascular etiology. The corpus cavernosum (CC) and the Internal Pudendal Artery (IPA) are the critical vascular structures related to erectile function. This study suggests that it is feasible to markedly decrease radiation dose to the CC and the IPA and directly determine the impact of dose limitation on potency. Methods and Materials: Twenty-five patients (10 external beam, 15 brachytherapy) underwent MRI/CT-based treatment planning for prostate cancer. In addition, 10 patients entered on the vessel-sparing protocol underwent a time-of-flight MRI angiography sequence to define the IPA. The distance from the MRI-defined prostate apex to the penile bulb (PB), CC, and IPA was measured and compared to the distance from the CT-defined apex. Doses (D5 and D50) to the PB, CC, and IPA were determined for an 80 Gy external beam course. In 5 patients, CT plans were generated and compared to MRI-based plans. Results: The combination of coronal, sagittal, and axial MRI data sets allowed superior definition of the prostate apex and its relationship to critical vascular structures. The apex to PB distance averaged 1.45 cm (0.36 standard deviation) with a range of 0.7 cm to 2.1 cm. Peak dose (D5) to the proximal CC in the MRI-planned 80 Gy course was 26 (9) Gy (0.36 of CT-planned dose), and peak dose to the IPA was 39 (13) Gy (0.61 of CT-planned dose). Conclusion: The distance between the prostate apex and critical vascular structures is highly variable. Current empiric rules for CT contouring (apex 1.5 cm above PB) overestimate or underestimate the distance between the prostate apex and critical vascular structures. When defined by MRI T2 and MRI angiogram with CT registration, limitation of dose to critical erectile structures is possible, with a more significant gain than has been previously reported using dose limitation by commonly applied intensity modulated radiation therapy studies based on CT imaging. These techniques make “vessel-sparing” prostate radiotherapy feasible. © 2005 Elsevier Inc.