Radiation Exposure during Prostatic Artery Embolization: A Single Institution Review

Area of Science:

• Radiology
• Interventional Radiology
• Medical Physics

Background:

• Prostate artery embolization (PAE) is a key treatment for benign prostatic hyperplasia (BPH).
• Diagnostic imaging during PAE is crucial but contributes significantly to radiation exposure for patients and healthcare professionals.
• Minimizing radiation exposure during PAE is an ongoing objective.

Purpose of the Study:

• To evaluate radiation emission during PAE procedures at a single institution.
• To identify factors predicting radiation exposure, aiming to minimize it.
• To analyze the relationship between patient characteristics, procedural extent, and radiation dose.

Main Methods:

• Retrospective analysis of 56 patients undergoing unilateral/bilateral PAE between January 2019 and November 2021.
• Data collected included patient demographics (BMI, prostate volume) and procedural parameters (air kerma, fluoroscopy time, acquisitions).
• Statistical analyses (Fisher's t-test, ANOVA, chi-square) were employed to determine significant predictors (P < 0.05).

Main Results:

• Increased body mass index (obesity) was a significant predictor of higher air kerma (radiation dose).
• Prostate size and the extent of embolization (bilateral vs. unilateral) were not significantly associated with increased air kerma.
• Despite higher acquisition numbers in bilateral PAE, radiation dose did not significantly increase.

Conclusions:

• Elevated body mass index is a key factor driving increased radiation exposure during PAE.
• Contrary to expectations, the extent of embolization (unilateral vs. bilateral) did not significantly impact radiation dose.
• Enhanced radiation protection strategies should be prioritized for patients with higher BMI to safeguard both patients and practitioners.