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

ABSTRACT

PURPOSE: The purpose of this study was to report the use of three-dimensional (3D) cone-beam computed tomography (CBCT) for prostatic artery embolization (PAE) in patients with benign prostatic hypertrophy (BPH). MATERIALS AND METHODS: Twenty-three consecutive men who underwent PAE using 3D CBCT from June 2016 to September 2018, were retrospectively included in this observational single-center study. There were 23 men with a mean age of 73±12 (SD) years (range 52-94years) with moderate to severe lower urinary tract symptoms (mean international prostate symptom score, 21±5.7 [SD]; range 9-30) due to BPH (mean prostate weight, 100g±63 [SD]; range 30-250g). PAEs were analyzed with respect to procedure time, fluoroscopy time, technical success, complications and dosimetric indices. RESULTS: The mean catheterization time of the prostatic artery from the internal iliac artery was 17.3±12.5 (SD) min (range 8-57min) on the right side and 23.6±14.9 (SD) min (range 6-54min) on the left side. A technical success was achieved in 21 patients (21/23; 91%). PAE was bilateral in 14 patients (14/21; 66%) and unilateral in 7 patients (7/21; 33%). No occurrence of non-target embolization was reported. The mean dose area product was 146.7±47.9 (SD) Gy.cm2 (range 54-254Gy.cm2) and mean cumulative air kerma was 771.4±333.3 (SD) mGy; range 280-1560 mGy. The mean fluoroscopy time was 42.3±23.1 (SD) min (range 19.4-118.2min). CONCLUSION: 3D CBCT is a useful tool to identify the prostatic arteries and facilitates catheterization of prostatic arteries with an acceptable level of radiation exposure.