Radiation Exposure During Outpatient Prostatic Artery Embolization Using Mobile C-Arm in 2,661 Patients

Wednesday, April 2, 2025

11:33 AM – 11:42 AM CT

Location: Music City Center, 205 A

Presenting Author(s)

Rylie Ju

Medical Student
University of Texas Medical Branch at Galveston, United States

Author/Co-author(s)

Sandeep Bagla, MD

President
IR Centers, Prostate, Hemorrhoid & Ortho Centers Network, United States
Abin Sajan, MD

Resident
Columbia Irving Medical Center, United States
Alex Pavidapha, MD

Vascular & Interventional Radiologist
IR Centers USA, United States

Purpose: Prostate artery embolization (PAE) has been supported to be a safe and efficacious treatment of benign prostatic hyperplasia associated lower urinary tract symptoms (BPH-LUTS), with recent endorsement from the American Urological Association. However, concerns regarding radiation exposure remain due to the procedural complexity. This study aims to evaluate the radiation exposure associated with PAE performed in multiple outpatient settings using mobile C-arm fluoroscopy units.

Materials and Methods: Retrospective review was conducted for patients who underwent PAE to treat BPH-LUTS from August 2021 and March 2024. All cases were performed at one of 3 outpatient centers with a single experienced operator using a mobile C-arm (Zenition 70, Philips Healthcare). Patient characteristics, procedural outcomes, and radiation exposure data including fluoroscopy time, cumulative air kerma (CAK), and kerma-area product (KAP) were recorded. Effective radiation doses for the procedure were determined by multiplying the KAP values with a standardized conversion factor specific to abdominopelvic fluoroscopy-guided interventions. Linear regression was used to analyze the relationships between CAK or effective dose with factors such as patient body mass index (BMI) and fluoroscopy time.

Results: A total of 2,661 patients (mean age, 67.8 years ± 8.0) were included. Successful bilateral embolization was achieved in 98±2% of procedures. Mean fluoroscopy time was 19.49±10 min and median procedure effective dose was 6.37 mSv (range, 4.1–9.9 mSv). CAK and effective dose both correlated positively with BMI (R2=0.15 and 0.18; P< .001) and fluoroscopy time (R2=0.52 and 0.17; P< .001). No centers reported adverse events from radiation exposure within 90 days after PAE.

Conclusion: Patients who underwent outpatient PAE with mobile fluoroscopy experienced minimal radiation exposure, with a median effective dose of 6.37 mSv, and no radiation-related adverse events reported within 90 days.