A preliminary study on application value of Cone Beam CT in prostate arterial embolization

Abstract

Objective: To evaluate the clinical value of Cone Beam CT(CBCT) technology in prostatic artery embolization (PAE) in treating prostatic hyperplasia. Methods: A retrospective analysis of clinical data of 12 patients with benign prostate hyperplasia who received PAE in our department during June 2015 to December 2016 was performed. Polyvinyl alcohol (PVA) particles were used as embolization agent intraoperatively. CBCT was running during the PAE procedure to ensure a clear prostate gland artery intubation, preventing non-target organs embolization by mistake. Confirmed by CBCT, 100 μm to 300 μm diameter of PVA particles were injected into the prostate gland artery. The postoperative follow-up was made to observe these patients status with hematuria and any complications caused by embolization. Results: All of the patients were performed CBCT examination under DSA. 10 patients (83.3%) received bilateral prostatic artery embolism while the other 2 (16.7%) patients received unilateral prostatic artery embolism due to curved artery. All patients received embolization with CBCT imaging confirmation. 8 patients’ urine tubes were removed successfully 1~2 weeks after the procedure, and these patients kept urine unobstructed without hematuria in the follow-up a month later, with efficiency being 67.7% (8/12) . Among the 3 patients with hematuria symptoms, the blood did not appear in the urine during the follow-up, thus, the hemostatic effectiveness was 100%. No serious complications of ischemic necrosis in adjacent organs such as the bladder, rectum, and penis were observed. Conclusion: CBCT plays an important role in guiding PAE in precision and avoiding the postoperative complications. Key words: Prostatic hyperplasia; Hematuria; Cone-Beam computed tomography; Embolism; Prostate arteries; Polyvinyl alcohol