Dual-energy computed tomography in supporting prostatic artery embolization for benign prostatic hyperplasia

Area of Science:

• Interventional Radiology
• Medical Imaging
• Urology

Background:

• Benign prostatic hyperplasia (BPH) is a common condition requiring effective treatment.
• Prostatic artery embolization (PAE) is an established minimally invasive treatment for BPH.
• Accurate pre-procedural imaging is crucial for successful PAE.

Purpose of the Study:

• To evaluate the utility of 256-slice dual-energy computed tomography (DECT) in planning PAE for BPH.
• To compare imaging and procedural outcomes between PAE with and without pre-procedural DECT.
• To assess DECT's ability to visualize prostatic artery anatomy.

Main Methods:

• Retrospective analysis of 88 patients undergoing PAE for BPH.
• Group 1 (n=38): PAE without DECT. Group 2 (n=50): PAE with pre-procedural DECT.
• Comparison of DECT and digital subtraction angiography (DSA) for prostatic artery (PA) visualization. Statistical analysis using T-student and Mann-Whitney tests.

Main Results:

• DECT detected PA origin in 96.1% of cases and identified atherosclerosis with high specificity (89.5%).
• No significant difference in PA diameter between DECT and DSA.
• Group 2 (with DECT) showed significant reductions in procedure time (-25.8%), fluoroscopy time (-23.2%), dose-area product (-25.6%), and contrast volume (-33.1%) compared to Group 1.

Conclusions:

• DECT is a valuable tool for pre-PAE planning in BPH patients.
• 3D rendering of prostatic arteries using DECT provides critical anatomical information.
• DECT-guided PAE optimizes procedural efficiency and reduces patient exposure to radiation and contrast media.