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SIR 2025

Men's Health

Traditional Poster

Session: Traditional Poster Presentations

74 - Optimizing Radiation Safety in Prostate Artery Embolization for Benign Prostatic Hyperplasia: The Role of Advanced Imaging Modalities in Reducing Radiation Exposure

Monday, March 31, 2025
12:10 PM – 1:10 PM CT
Location: Music City Center, Expo Poster Area
Purpose: Prostate artery embolization (PAE) is a growing minimally invasive treatment for benign prostatic hyperplasia (BPH), with imaging modality selection playing a critical role in determining procedural radiation exposure. This study provides a detailed comparative analysis of radiation doses across three imaging modalities, while adjusting for anatomical variations in the patient cohort. As PAE becomes more widely adopted as a minimally invasive treatment for BPH, minimizing radiation exposure is paramount in improving patient safety and reducing long-term complications.

Materials and Methods: A retrospective cohort study was conducted on 94 PAE cases between 2018-2024 for BPH, stratified by imaging modality: Fluoroscopy alone (FL), Fluoroscopy with Cone-Beam CT (FL-CBCT), and Fluoroscopy with Cone-Beam CT and Navigation Software (FL-CBCT-NS) (Emboguide Phillips Healthcare). The primary outcome measure was radiation dose (mGy), with secondary adjustments for the presence of anatomical variation classified binarily. Multivariate regression analysis was employed to control for the presence of anatomic variants.

Results: Descriptive analysis revealed the highest median radiation dose in the FL group (4549.0 mGy), followed by FL-CBCT (1928.0 mGy), and the lowest in the FL-CBCT-NS group (1714.5 mGy). Multivariate analysis demonstrated a significant increase in radiation dose for FL (+1868.56 mGy, p</span><0.01) and a substantial reduction in radiation dose for FL-CBCT-NS (-1412.63 mGy, p</span><0.05). Anatomical variation was not a significant predictor of radiation dose (p >0.5), suggesting that procedural radiation exposure is predominantly influenced by imaging modality selection.

Conclusion: The incorporation of advanced imaging technologies, particularly CBCT and navigation software, is associated with a significant reduction in radiation exposure during PAE for BPH, independent of anatomical complexity. These findings advocate for a broader implementation of multimodal imaging technologies in interventional radiology, particularly in high-volume centers aiming to optimize procedural outcomes.