Does Preprocedural CT Angiography Improve Prostate Artery Embolization Procedure Time and Radiation Dose Compared to MRI?

Tuesday, April 1, 2025

3:18 PM – 3:27 PM CT

Location: Music City Center, 204

Presenting Author(s)

SF

Samuel Fordyce, MD

Resident Physician
Columbia University, United States

Author/Co-author(s)

Abin Sajan, MD

Resident
Columbia Irving Medical Center, United States
Connie Liou, MD

Resident Physician
Columbia University, United States
EK

Eleanor Kim, MD

Resident Physician in Interventional/Diagnostic Radiology
New York Presbyterian/Columbia, United States
HB

Hannah Bae, MD

Assistant Professor Interventional Radiology
Columbia University, United States
LY

Lindsay Young, MD

Assistant Professor Interventional Radiology
Columbia University Irving Medical Center, United States
Kiyon Naser-Tavakolian, MD

Assistant Professor Interventional Radiology
Columbia University, United States

Purpose:

Preprocedural imaging for prostate artery embolization (PAE) is typically obtained to assess prostate size, preprocedural vessel mapping and to evaluate for any potential malignancy. The choice of imaging is often decided by the operator based on patient factors. We sought to evaluate whether preprocedural imaging choice could reduce procedure time and radiation dose.

Materials and Methods:

This was an IRB approved retrospective study of 143 PAE performed between February 2020 and June 2024. Each procedure was reviewed to determine which form of imaging was obtained or available prior to the procedure. Those that obtained a CT angiography (CTA) were compared to those that obtained MRI. Fluoroscopy time (minutes), radiation entry skin dose (mGy), prostate size (g), International Prostate Symptom Score (IPSS), and prostate specific antigen (PSA) levels were compared between the two groups for statistical significance.

Results:

53 patients (average age 71.7) had CTA prior to their procedure and 90 patients (average age 67.7) had an MRI. Technical success in the CTA group was 96.2% and 97.8% in the MRI group (2 technical failures in each group). No significant difference was between preprocedural CTA and MRI for average fluoroscopy time (44.6 minutes +/-17.4 and 49.3 minutes +/-17.7, respectively, p = 0.224), radiation dose (4008mGy +/- 2603 and 3406mGy +/- 2158, p = 0.13), prostate size (130.2g vs 124.6g, p = 0.62), IPSS score (22.0 vs 22.7, p = 0.69), and PSA level (6.57 vs. 7.20, p = 0.69).

Conclusion:

Preprocedural imaging has utility in assessing prostate size and aids in preprocedural planning. The decision between CTA or MRI does not appear to influence procedure fluoroscopy time or radiation dose to the patient. Further studies comparing the two modalities are suggested.