Longitudinal Changes in U.S. Parameters of Neurovascular Bundles Suggest Mechanism for Radiation-Induced Erectile Dysfunction

• Type of Material: Article
• Authors: James R Janopaul-Naylor, Emory University; Tian Liu, Emory University; Boran Zhou, Emory University; Xiaofeng Yang, Emory University; Neal S McCall, Emory University; Pretesh Patel, Emory University; Akanksha Mehta, Emory University; Sherif Nour, Emory University; Ashesh Jani, Emory University
• Language: English
• Date: 2022-09-01
• Publisher: Elsevier Inc.
• Publication Version: Final Published Version
• Copyright Statement: © 2022 The Author(s)
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.adro.2022.100946
• Title of Journal or Parent Work: Advances in Radiation Oncology
• Volume: 7
• Issue: 5
• Start Page: 100946
• End Page: 100946
• Grant/Funding Information: This work was supported by Department of Defense Grants PC160820 (Principal Investigator: Dr Tian Liu) and PC160820P1 (Principal Investigator: Dr Ashesh B. Jani).
• Keywords: Radiation; Neurovascular Bundles; Erectile Dysfunction
• Research Categories: Health Sciences, Radiology

Abstract

Up to 50% of patients with prostate cancer report erectile dysfunction (ED) after treatment.1 The mechanism of radiation-induced erectile dysfunction remains unknown.2 Previously damage to the penile bulb was thought to be causal,3 but may be a surrogate given lack of clear dose-volume constraints.4 Recent investigations focus on the neurovascular bundles (NVB).5 NVB-sparing radiation therapy has been demonstrated to be feasible in terms of contour reproducibility6 and radiation therapy planning,7 including in the presence of SpaceOAR8 or with boost to dominant intraprostatic lesion.9 However, functional assessments of NVB before and after radiation have not been reported. We document a case series of longitudinal quantitative transrectal ultrasound (TRUS) and Doppler assessment of NVB function to evaluate the effect of radiation therapy on patient-reported ED.