Application of cone-beam CT in prostatic arterial embolization

Abstract

Objective To explore the utility of cone-beam CT in the evaluation of prostatic arterial embolization (PAE). Methods In a retrospective study, images of DSA and cone-beam CT for PAE in 81 patients with moderate to severe grade benign prostatic hyperplasia were evaluated. In 162 cases of internal iliac arteries (Ⅱ As) in 81 patients, images of 6 Ⅱ As were excluded due to the technical problems. Therefore, images of 156 Ⅱ As were included for evaluation. We aim to evaluate the utility of cone-beam CT versus DSA in differentiating PAs and their origins, and demonstrating anastomoses with adjacent arteries. Statistical analyses were performed with Chi-square test to compare the rate of demonstrating vessels between cone-beam CT and DSA. Results One hundred and sixty-one PAs were demonstrated in 156 Ⅱ As by selective DSA and Cone-beam CT. Cone-beam CT and DSA images demonstrated 158 (98.1%, 158/161) and 130 (80.8%, 130/161) PAs, respectively. The statistical difference was significant (χ2=25.78,P<0.05). PAs were demonstrated by cone-beam CT images alone in 27 Ⅱ As (17.3%, 27/156) and were demonstrated by DSA images alone in 3 Ⅱ As (1.9%, 3/161).The statistical difference was significant (χ2=22.31,P<0.05). In 137 PAs that were initially defined by DSA alone, 7 of those (5.1%, 7/137) were eventually proven not to be PAs by further selective cone-beam CT acquisitions. Origins of PAs were shown by Cone-beam CT images alone in 11 Ⅱ As. In the remaining 145 Ⅱ As (92.9%, 145/156), origins of PAs were shown by both cone-beam CT and DSA images. The percentage of PA anastomoses demonstrated by cone-beam CT was 42.3% (66/156), which was higher than DSA (31.4%, 49/156). The statistical difference was significant (χ2= 3.98,P<0.05). Conclusions Cone-beam CT is useful in demonstrating PAs and their origins from Ⅱ As, as well as anastomoses with adjacent arteries. Key words: Prostatic hyperplasia; Embolization,therapeutic; Tomography,X-ray computed