Prostatic artery embolization using three-dimensional cone-beam computed tomography

Area of Science:

• Interventional Radiology
• Medical Imaging
• Urology

Background:

• Benign prostatic hypertrophy (BPH) affects a significant number of aging men, leading to lower urinary tract symptoms.
• Prostatic artery embolization (PAE) is an emerging minimally invasive treatment option for BPH.
• Accurate visualization of prostatic arteries is crucial for successful PAE.

Purpose of the Study:

• To evaluate the utility of three-dimensional (3D) cone-beam computed tomography (CBCT) in guiding prostatic artery embolization (PAE).
• To assess the technical success, procedure time, and radiation exposure associated with 3D CBCT-assisted PAE for benign prostatic hypertrophy (BPH).

Main Methods:

• Retrospective observational study of 23 men with BPH undergoing PAE using 3D CBCT.
• Analysis of procedure time, fluoroscopy time, technical success rates, and complications.
• Dosimetric indices, including dose area product and cumulative air kerma, were recorded.

Main Results:

• Technical success was achieved in 91% of patients (21/23).
• Mean fluoroscopy time was 42.3±23.1 minutes.
• No non-target embolization occurred, and radiation exposure was deemed acceptable.

Conclusions:

• Three-dimensional cone-beam computed tomography (3D CBCT) is a valuable tool for identifying and facilitating catheterization of prostatic arteries.
• 3D CBCT-assisted PAE offers a high technical success rate with manageable radiation doses for BPH treatment.