Download PDF
CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2022; 06(02): 090-097
DOI: 10.1055/s-0041-1740575
Original Article

Cone Beam CT with Automatic vessel Detection Software versus Conventional 2D Fluoroscopy with Overlay for Prostate Artery Embolization: A Comparison of Prostatic Artery Catheterization Time and Radiation Exposure

Vedant Acharya
1   University of Miami Miller School of Medicine, Miami, Florida, United States
,
Hamed Jalaeian
2   Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
,
Srinivas Tummala
2   Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
,
Kush Shah
3   Department of Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, United States
,
Jessica Kumar
3   Department of Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, United States
,
Issam Kably
2   Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
,
Shivank Bhatia
2   Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
› Author Affiliations Funding This study was supported in part by a grant from Siemens Healthcare Diagnostics, (Grant/Award Numbers: MIAMI2016ATBHATIAC0022371)
› Further Information
   Permissions and Reprints

Abstract

Purpose To evaluate the effect of cone-beam computed tomography (CT) with automatic vessel detection software on prostate artery catheterization and fluoroscopy time in prostate artery embolization (PAE).

Methods Fifty patients undergoing PAE for BPH were enrolled in this prospective study. Twenty-five PAEs were performed using automatic vessel detection software with syngo embolization guidance (study) and were compared with 25 PAEs performed using conventional two-dimensional (2D) fluoroscopy with overlay (control). PAE was performed using 300–500 μm trisacryl gelatin spherical particles. The primary outcome parameters were prostatic artery catheterization time and fluoroscopy time.

Results Bilateral PAE was achieved in 24/25 cases in both groups. The median right and left prostatic artery catheterization times were similar between the two groups, (p = 0.473 and p = 0.659, respectively). The median fluoroscopy time (28.0 and 42.0 minutes, p = 0.046) and total procedure time (70.0 and 118.0 minutes, p < 0.001) were shorter in the study group. The median total dose area product (DAP) was not significantly different. However, the median CBCT DAP (11406 vs. 6248, p < 0.001) was higher in the study group, while median fluoroscopy DAP (7371 vs. 8426, p < .049) was higher in the control group. Median digital subtraction angiography (DSA), CBCT, and fluoroscopy DAP accounted for 27%, 45%, and 29% of the total DAP in the study group and 32%, 29%, and 39% in the control group (p < 0.001), respectively. All complications were Clavien–Dindo Grade 1.

Conclusion Although CBCT with automatic vessel detection software had no significant effect on time-to-prostatic artery catheterization and total radiation exposure, it reduced the fluoroscopy time and procedure time.

Keywords

prostate artery embolization - automatic vessel detection software - cone-beam computed tomography

Authors' Contributions

V Acharya: Acquisition/analysis, interpretation of data, drafting, and revision of submitted work.


H Jalaeian: Acquisition/analysis, interpretation of data, drafting, and revision of submitted work.


S Tummala: Acquisition/analysis, interpretation of data, drafting, and revision of submitted work.


K Shah: Acquisition/analysis, interpretation of data, drafting, and revision of submitted work.


J Kumar: Acquisition/analysis, interpretation of data, drafting, and revision of submitted work.


I Kably: Acquisition/analysis, interpretation of data, drafting, and revision of submitted work.


S Bhatia: Conception, design, acquisition, interpretation of data, drafting, revision, and final approval of submitted work.


Compliance with Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


Informed consent was obtained from all individual participants involved in the study


Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. IDE G130237, ClinicalTrials.gov Identifier NCT02173522.


Informed Consent

Informed consent was obtained from all individual participants included in the study.


Consent for Publication

The authors consent to the publisher's sole and exclusive license of the full copyright of the publication.


Statement of Data Access and Integrity

The authors declare that they had full access to all of the data in this study and the author take complete responsibility for the integrity of the data and the accuracy of the data analysis.




Publication History

Article published online:
02 July 2022

© 2022. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Bilhim T, Pisco JM, Rio Tinto H. et al. Prostatic arterial supply: anatomic and imaging findings relevant for selective arterial embolization. J Vasc Interv Radiol 2012; 23 (11) 1403-1415
    CrossrefPubMedGoogle Scholar
  • 2 Moya C, Cuesta J, Friera A, Gil-Vernet Sedó JM, Valderrama-Canales FJ. Cadaveric and radiologic study of the anatomical variations of the prostatic arteries: a review of the literature and a new classification proposal with application to prostatectomy. Clin Anat 2017; 30 (01) 71-80
    CrossrefPubMedGoogle Scholar
  • 3 de Assis AM, Moreira AM, de Paula Rodrigues VC. et al. Pelvic arterial anatomy relevant to prostatic artery embolisation and proposal for angiographic classification. Cardiovasc Intervent Radiol 2015; 38 (04) 855-861
    CrossrefPubMedGoogle Scholar
  • 4 Bagla S, Rholl KS, Sterling KM. et al. Utility of cone-beam CT imaging in prostatic artery embolization. J Vasc Interv Radiol 2013; 24 (11) 1603-1607
    CrossrefPubMedGoogle Scholar
  • 5 Wang MQ, Duan F, Yuan K, Zhang GD, Yan J, Wang Y. Benign prostatic hyperplasia: cone-beam CT in conjunction with DSA for identifying prostatic arterial anatomy. Radiology 2017; 282 (01) 271-280
    CrossrefPubMedGoogle Scholar
  • 6 Chiaradia M, Radaelli A, Campeggi A, Bouanane M, De La Taille A, Kobeiter H. Automatic three-dimensional detection of prostatic arteries using cone-beam CT during prostatic arterial embolization. J Vasc Interv Radiol 2015; 26 (03) 413-417
    CrossrefPubMedGoogle Scholar
  • 7 Schott P, Katoh M, Fischer N, Freyhardt P. Radiation dose in prostatic artery embolization using cone-beam CT and 3D Roadmap software. J Vasc Interv Radiol 2019; 30 (09) 1452-1458
    CrossrefPubMedGoogle Scholar
  • 8 Lin P-JP, Schueler BA, Balter S. et al. Accuracy and calibration of integrated radiation output indicators in diagnostic radiology: a report of the AAPM Imaging Physics Committee Task Group 190. Med Phys 2015; 42 (12) 6815-6829
    CrossrefPubMedGoogle Scholar
  • 9 Bhatia S, Sinha V, Bordegaray M, Kably I, Harward S, Narayanan G. Role of coil embolization during prostatic artery embolization: incidence, indications, and safety profile☆ . J Vasc Interv Radiol 2017; 28 (05) 656-664.e3
    CrossrefPubMedGoogle Scholar
  • 10 Floridi C, Radaelli A, Abi-Jaoudeh N. et al. C-arm cone-beam computed tomography in interventional oncology: technical aspects and clinical applications. Radiol Med (Torino) 2014; 119 (07) 521-532
    CrossrefPubMedGoogle Scholar
  • 11 Lechuga L, Weidlich GA. Cone beam CT vs. fan beam CT: a comparison of image quality and dose delivered between two differing CT imaging modalities. Cureus 2016; 8 (09) e778
    PubMedGoogle Scholar
  • 12 Maclean D, Maher B, Harris M. et al. Planning prostate artery embolisation: is it essential to perform a pre-procedural CTA?. Cardiovasc Intervent Radiol 2018; 41 (04) 628-632
    CrossrefPubMedGoogle Scholar
  • 13 Desai H, Yu H, Ohana E, Gunnell ET, Kim J, Isaacson A. Comparative analysis of cone-beam CT angiogram and conventional CT angiogram for prostatic artery identification prior to embolization. J Vasc Interv Radiol 2018; 29 (02) 229-232
    CrossrefPubMedGoogle Scholar
  • 14 Schnapauff D, Maxeiner A, Wieners G. et al. Semi-automatic prostatic artery detection using cone-beam CT during prostatic arterial embolization. Acta Radiol 2020; 61(8): 1116-1124
    CrossrefPubMedGoogle Scholar