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Pulsed Wave Doppler Parameters of Bilateral Neurovascular Bundles in Patients Receiving Prostate Radiotherapy

B Zhou*, X Yang, J Wang, J Janopaul-naylor, P Patel, A Jani, T Liu, Emory Univ, Atlanta, GA

Presentations

TU-J430-BReP-F3-5 (Tuesday, 7/12/2022) 4:30 PM - 5:30 PM [Eastern Time (GMT-4)]

Exhibit Hall | Forum 3

Purpose: To explore the pulsed wave Doppler features of bilateral neurovascular bundles (NVBs) for patients receiving prostate radiotherapy.

Methods: Sixteen patients (mean age 70.4 ± 8.2 years) receiving prostate radiotherapy were enrolled under IRB approval. Each patient received a transrectal US scan with a mechanical stepper holding the probe. The US scans involved: 1) 3D B-mode scans of the entire prostate, 2) localizations of NVBs with color flow Doppler imaging, 3) pulsewave measurement of the NVBs. Five pulsed Doppler waveform features were extracted using an in-house program: peak-systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (Vm), resistive index (RI), and pulsatile index (PI). The discrepancy in blood flow between left and right NVBs was assessed in Vm percent difference ([max - min]/min x 100%).

Results: Bilateral NVB locations were reviewed by an experienced radiation oncologist and Doppler waveform features were successfully obtained. The Doppler pulsed waveform parameters ranged from PSV = 4.93 – 17.83 cm/s, EDV = 0 – 4.35 cm/s, Vm = 1.29 – 7.81 cm/s, RI = 0.3 – 2.63, and PI = 0.62 – 3.64. Among these patients, a large discrepancy in pulsed waveform parameters of left and right NVBs were observed (PSV = 8 - 215 %, Vm = 7 - 171 %, RI = 3 - 415 %, PI = 0 – 125 %). Blood flow discrepancy between left and right NVB was less than 50% in 6 patients (38%), 51-100% in 9 patients (56%), and >100% in 1 patient (6%).

Conclusion: In the first of its kind Doppler study of the NVBs in patients receiving prostate radiotherapy, we report a large discrepancy in the Doppler ultrasound waveform features between bilateral NVBs. The proposed ultrasound method can be useful as clinicians develop vessel-sparing radiotherapy to more effectively preserve sexual function and improve patient overall wellbeing.

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