Radiation Exposure and Dosimetry in Prostate Artery Embolization Using N-Butyl Cyanoacrylate: A Dosimetric Analysis

Wednesday, April 2, 2025

11:24 AM – 11:33 AM CT

Location: Music City Center, 205 A

Presenting Author(s)

Ramita N. Gowda, MPH

Medical Student
St. George's University School of Medicine, United States

Author/Co-author(s)

Jade Lerner, MD (she/her/hers)

Resident
Icahn School of Medicine at Mount Sinai, United States
David Bamshad, MD

Fellow PGY6
The Mount Sinai Hospital, United States
AG

Adam Geffner, BA

Medical Student
Icahn School of Medicine, United States
JV

Jenanan Vairavamurthy, MD

Assistant Professor of Radiology
Mount Sinai, United States
Dan Shilo, MD

Assistant Professor
Mount Sinai, United States
KG

Kirema Garcia-Reyes, MD

Assistant Professor
Mount Sinai, United States
Vivian Bishay, MD

Associate Professor
Icahn School of Medicine at Mount Sinai Hospital, United States
RP

Rajesh I. Patel, MD

Assistant Professor of Radiology and Surgery
Icahn School of Medicine at Mount Sinai, United States
Robert A. Lookstein, MD

Professor of Radiology and Surgery
Icahn School of Medicine at Mount Sinai, United States
AF

Aaron M. Fischman, MD

Professor of Radiology and Surgery
Mount Sinai Health System, United States

Purpose:

Prostate artery embolization (PAE) is increasingly used to treat benign prostatic hyperplasia (BPH) and other prostatic conditions. This procedure, however, involves exposure to ionizing radiation, which raises concerns regarding long-term radiation risks. N-butyl cyanoacrylate (n-BCA) has emerged as a potential embolic agent, offering quicker procedural times compared to traditional microparticles (mp). This study aims to evaluate the radiation exposure and dosimetric outcomes of PAE using n-BCA, focusing on radiation dose-area product (DAP) and fluoroscopy time (FT).

Materials and Methods:

A retrospective analysis was performed on patients who underwent mp-PAE from 7/2019 to 6/2022 and n-BCA-PAE from 6/2022-5/2024. A total of 352 patients were included, with 231 undergoing n-BCA-PAE and 121 undergoing mp-PAE. PAE via trans-radial access was performed with a 1:10 n-BCA:lipiodol mixture for the n-BCA cohort and 200-400 um microparticles for the mp cohort. Radiation metrics, including DAP and FT were collected. Technical success (bilateral embolization) and adverse events were also assessed.

Results:

The average age of men treated was 71.5 with an overall technical success of 96%. The n-BCA group demonstrated statistically significant reduced mean DAP of 21,110 uGym2 compared to 26,271 uGym2 in the mp group (p=0.01). The n-BCA group also demonstrated statistically significant reduced mean FT of 24.8 minutes compared to 36.0 minutes in the mp group (p< 0.001). There were no major adverse events reported.

Conclusion: PAE with n-BCA resulted in significantly reduced radiation exposure and procedural time compared to mp-PAE, without compromising technical success of safety. These findings suggest that n-BCA may be a preferable embolic agent in terms of dosimetric efficiency.