MR angiography-planned prostatic artery embolization for benign prostatic hyperplasia: single-center retrospective study in 56 patients

Abstract

PURPOSE We aimed to evaluate the advantages of magnet onance angiography (MRA)-planned prostatic artery embolization (PAE) for benign prost hyperplasia (BPH). METHODS In this retrospective study, MRAs of 56 patients (mean age, 67.23 +/- 7.73 years; age , 4782 years, who under went PAE between 2017 and 2018 were evaluated. For inclusion, full information about procedure time and radiation values must have been available. To identify prostatic artery (PA) origin, three-dimensional MRA reconstruction with maximum intensity projection was conducted in every patient. In total, 33 patients completed clinical and imaging follow-up and were included in clinical evaluation. RESULTS There were 131 PAs with a second PA in 19 pelvic sides. PA origin was correctly identified via MRA in 108 of 131 PAs (82.44%). In patients in which MRA allowed a PA analysis, a significant reduction of the fluoroscopy time (-27.0%, p = 0.028) and of the dose area product (-38.0%, p = 0.003) was detected versus those with no PA analysis prior to PAE. Intervention time was reduced by 13.2%, (p = 0.25). Mean fluoroscopy time was 30.1 min, mean dose area product 27,749 mu Gy.m2, and mean entrance dose 1553 mGy. Technical success was achieved in all 56 patients (100.0%); all patients were embolized on both pelvic sides. The evaluated data documented a significant reduction in international prostate symptom scores (p < 0.001; mean 9.67 points). CONCLUSION MRA prior to PAE allowed the identification of PA in 82.44% of the cases. MRA-planned-PAE is an effective treatment for patients with BPH.