Contrast-enhanced magnetic resonance angiography can accurately show the anatomy of prostate arteries, potentially enabling shorter prostatic artery embolization (PAE) times for benign prostatic hyperplasia (BPH), a new study suggests.

Writing in Radiology, Chinese researchers report that contrast-enhanced magnetic resonance (MR) angiography demonstrated high sensitivity and positive predictive value in detecting the origins, trajectory, and number of prostatic arteries prior to PAE, a major technical challenge when performing the procedure. The challenge is even greater when atherosclerosis and variant prostatic vascular anatomy are present. In these cases, procedures take longer and higher doses of fluoroscopy-related radiation are required.

Jin Long Zhang, MD, and colleagues from the Chinese PLA General Hospital, Beijing Provence China, prospectively analyzed the use of gadolinium-enhanced MR angiography in 100 consecutive men (mean age 72 years) scheduled to undergo PAE for BPH. Investigators randomly assigned 50 men to undergo PAE without prior MR angiography (group A) and 50 to undergo MR angiography prior to PAE (group B).

Compared with digital subtraction angiography as the reference, MR angiography identified prostatic arteries with a sensitivity of 91.5% and a positive predictive value of 100%. Compared with group A, group B procedure times and fluoroscopy times were shorter (82.3 vs 123.9 minutes and 13.8 vs 28.5 minutes, respectively). Median radiation doses were 920 mGy in group A compared with 339 mGy in Group B.

Reference

Zhang JL, Wang MQ, Shen YG, et al. Effectiveness of contrast-enhanced MR angiography for visualization of the prostatic artery prior to prostatic arterial embolization. Radiology 2019; published online ahead of print.

https://doi.org/10.1148/radiol.2019181524