Intra-Arterial and Intravenous Contrast-Enhanced Ultrasonography in Prostate Artery Embolization: A Case Series

Area of Science:

• Radiology
• Interventional Radiology
• Medical Imaging

Background:

• Prostatic arterial embolization (PAE) is an emerging treatment for benign prostatic hyperplasia.
• Accurate guidance and confirmation of embolization are crucial for successful PAE.
• Contrast-enhanced ultrasound (CEUS) offers real-time visualization during interventional procedures.

Purpose of the Study:

• To evaluate the early experience and feasibility of using intra-arterial (IA) and intravenous (IV) CEUS in patients undergoing PAE.
• To assess the role of IA CEUS in confirming catheter placement and visualizing prostatic artery perfusion.
• To determine the utility of IV CEUS in confirming the procedural endpoint of PAE.

Main Methods:

• Retrospective case series of 8 patients undergoing PAE between July 2014 and March 2017.
• IA CEUS was used to interrogate prostatic arteries (PAs) for perfusion and confirm catheter position.
• IV CEUS was performed in a subset of patients to assess post-embolization enhancement.

Main Results:

• Technical success of PAE was achieved in 7 out of 8 patients.
• IA CEUS successfully demonstrated ipsilateral prostatic perfusion in 15/20 PAs and confirmed correct catheter placement.
• Extraprostatic perfusion was identified in 4/20 PAs, and IV CEUS confirmed decreased enhancement post-embolization in all 4 evaluated patients.

Conclusions:

• IA and IV CEUS are feasible and valuable adjuncts for guiding and confirming PAE.
• IA CEUS aids in precise catheter navigation and assessment of prostatic perfusion.
• IV CEUS effectively confirms successful embolization, serving as a reliable procedural endpoint.