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PURPOSE: To evaluate the advantages of MR angiography (MRA)-planned prostatic artery embolization (PAE) for benign prostatic hyperplasia (BPH).
METHODS: In this retrospective study MRA’s of 56 patients (range: 47-82 years; mean: 67.23 ± 7.73 years) with a PAE between 2017 and 2018 were evaluated. For inclusion, full information about procedure time and radiation values must have been available. To identify prostatic artery (PA) origin, 3-dimensional MRA reconstruction with maximum intensity projection was conducted in every patient. 33 patients did complete clinical and imaging follow up and were included in clinical evaluation.
RESULTS: In total there were 131 PA’s with a second PA in 19 pelvic sides. PA origin was correctly identified via MRA in 108 of 131 PA’s (82.44%). In patients in which MRA allowed a PA analysis, a significant reduction of the fluoroscopy time (-27.0%, P = 0.028) and of the dose area product (-38.0%, P = 0.003) was detected versus those with no PA analysis prior to PAE. Intervention time was reduced by 13.2%, (p=0.25). Mean fluoroscopy time was 30.1 minutes, mean dose area product 27,749 µGym2 and mean entrance dose 1,553 mGy. Technical success was achieved in all 56 patients (100.0%); all patients were embolized on both pelvic sides. The evaluated data documented a significant reduction in IPSS (P < 0.001; mean 9.67 points).
CONCLUSION: MRA prior to PAE allowed the identification of PA in 82.44% of the cases. MRA-planned PAE is an effective treatment for patients with BPH.