Prostatic Artery Embolization: Indications, Preparation, Techniques, Imaging Evaluation, Reporting, and Complications

Area of Science:

• Interventional Radiology
• Urology
• Medical Imaging

Background:

• Benign prostatic hyperplasia (BPH) causes lower urinary tract symptoms (LUTS), impacting quality of life.
• Established BPH treatments include medications and surgery.
• Prostatic artery embolization (PAE) is an emerging minimally invasive option for BPH.

Purpose of the Study:

• To inform radiologists and interventional radiologists about PAE technical concepts.
• To highlight key imaging features for pre- and post-procedural PAE assessments.
• To emphasize the importance of comprehensive evaluations for successful PAE.

Main Methods:

• Review of technical aspects of PAE for BPH.
• Discussion of essential pre-procedural evaluations (clinical, laboratory, imaging).
• Outline of post-procedural assessment requirements, including imaging (US, MRI, CT).

Main Results:

• PAE is increasingly utilized in tertiary care settings for BPH.
• Successful PAE relies on thorough pre- and post-procedural imaging interpretation.
• Radiologists must understand PAE nuances for accurate reporting.

Conclusions:

• PAE offers a viable minimally invasive treatment for BPH with moderate to severe LUTS.
• Radiologists play a critical role in patient selection and treatment monitoring via imaging.
• Awareness of PAE techniques and imaging hallmarks is essential for interventional radiologists.