Using prostate contrast retention (PCR) as the procedural endpoint in prostatic artery embolization for benign...

Area of Science:

• Interventional Radiology
• Urology
• Vascular Imaging

Background:

• Prostate artery embolization (PAE) failure rates are approximately 20%, potentially due to incomplete embolization.
• Assessing embolization completeness via arterial contrast stasis on fluoroscopy may be insufficient.
• Prostate contrast retention (PCR) on immediate post-embolization cone-beam CT offers a potentially more accurate assessment.

Purpose of the Study:

• To evaluate the outcomes of PAE when using PCR adequacy as the procedural endpoint.
• To determine if PCR adequacy correlates with improved technical and clinical success in PAE.
• To assess the impact of PCR-guided PAE on patient-reported symptoms and outcomes.

Main Methods:

• Retrospective cohort study of 165 PAE patients at a high-volume center.
• Technical success defined as >75% global prostate gland contrast staining (adequate PCR).
• Clinical success assessed per CIRSE standards, with additional embolization if PCR was inadequate.

Main Results:

• High technical (98.8%) and clinical (96.4%) success rates were achieved.
• Adequate PCR was significantly associated with higher clinical success.
• Significant improvements in International Prostate Symptom Scores (IPSS), Quality of Life (QoL), prostate volume, and post-voiding residual volume were observed.

Conclusions:

• Utilizing PCR adequacy as the endpoint for PAE can lead to more complete embolization.
• This approach may significantly increase clinical success rates in PAE procedures.
• PCR adequacy assessment is a valuable tool for optimizing PAE outcomes.