Radiological Anatomy of Prostatic Arteries

Bilhim, Tiago; Tinto, Hugo Rio; Fernandes, Lúcia; Pisco, João Martins

doi:10.1053/j.tvir.2012.09.006

Cited by 76 publications

(62 citation statements)

References 9 publications

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“…The prevalence of anastomoses between PAs and adjacent arteries varies from 32% to 60%, depending on the method used (eg, DSA, CT angiography, or cadaveric dissection) (8)(9)(10)(11)(12)25). In our study, the rate of the anastomoses to adjacent arteries was documented in 22.6% of pelvic sides, which was lower than that in previous reports.…”

Section: Discussioncontrasting

confidence: 54%

Benign Prostatic Hyperplasia: Cone-Beam CT in Conjunction with DSA for Identifying Prostatic Arterial Anatomy

Wang¹,

Duan²,

Yuan³

et al. 2017

Radiology

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Purpose:To describe findings in prostatic arteries (PAs) at digital subtraction angiography (DSA) and cone-beam computed tomography (CT) that allow identification of benign prostatic hyperplasia and to determine the value added with the use of cone-beam CT. Materials and Methods:This retrospective single-institution study was approved by the institutional review board, and the requirement for written informed consent was waived. From February 2009 to December 2014, a total of 148 patients (mean age 6 standard deviation, 70.5 years 6 14.5) underwent DSA of the internal iliac arteries and cone-beam CT with a flat-detector angiographic system before they underwent prostate artery embolization. Both the DSA and conebeam CT images were evaluated by two interventional radiologists to determine the number of independent PAs and their origins and anastomoses with adjacent arteries. The exact McNemar test was used to compare the detection rate of the PAs and the anastomoses with DSA and with cone-beam CT. Results:The PA anatomy was evaluated successfully by means of cone-beam CT in conjunction with DSA in all patients. Of the 296 pelvic sides, 274 (92.6%) had only one PA. The most frequent PA origin was the common glutealpudendal trunk with the superior vesicular artery in 118 (37.1%), followed by the anterior division of the internal iliac artery in 99 (31.1%), and the internal pudendal artery in 77 (24.2%) pelvic sides. In 67 (22.6%) pelvic sides, anastomoses to adjacent arteries were documented. Conclusion:Cone-beam CT is a useful adjunctive technique to DSA for identification of the PA anatomy and provides information to help treatment planning during prostatic arterial embolization.q RSNA, 2016

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Section: Discussioncontrasting

confidence: 54%

Benign Prostatic Hyperplasia: Cone-Beam CT in Conjunction with DSA for Identifying Prostatic Arterial Anatomy

Wang¹,

Duan²,

Yuan³

et al. 2017

Radiology

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“…PAE is technically challenging, even for experienced VIR physicians. This is mainly related to the prostatic arterial vascular anatomy where significant anatomic variants of prostate arteries exist, in terms of their origin, number, and course 3. In addition, the prostate arteries often have very small diameters, on the order of 0.5 to 1.5 mm 4…”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional printing CT‐derived objects with controllable radiopacity

Hamedani

Melvin

Vaheesan

et al. 2018

J Applied Clin Med Phys

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PurposeThe goal of this work was to develop phantoms for the optimization of pre‐operative computed tomography (CT) scans of the prostate artery, which are used for embolization planning.MethodsAcrylonitrile butadiene styrene (ABS) pellets were doped with barium sulfate and extruded into filaments suitable for 3D printing on a fused deposition modeling (FDM) printer. Cylinder phantoms were created to evaluate radiopacity as a function of doping percentage. Small‐diameter tree phantoms were created to assess their composition and dimensional accuracy. A half‐pelvis phantom was created using clinical CT images, to assess the printer's control over cortical bone thickness and cancellous bone attenuation. CT‐derived prostate artery phantoms were created to simulate complex, contrast‐filled arteries.ResultsA linear relationship (R = 0.998) was observed between barium sulfate added (0%–10% by weight), and radiopacity (−31 to 1454 Hounsfield Units [HU]). Micro‐CT scans showed even distribution of the particles, with air pockets comprising 0.36% by volume. The small vessels were found to be oversized by a consistent amount of 0.08 mm. Micro‐CT scans revealed that the phantoms' interiors were completely filled in. The maximum HU values of cortical bone in the phantom were lower than that of the filament, a result of CT image reconstruction. Creation of cancellous bone regions with lower HU values, using the printer's infill parameter, was successful. Direct volume renderings of the pelvis and prostate artery were similar to the clinical CT, with the exception that the surfaces of the phantom objects were not as smooth.ConclusionsIt is possible to reliably create FDM 3D printer filaments with predictable radiopacity in a wide range of attenuation values, which can be used to print dimensionally accurate radiopaque objects derived from CT data. Phantoms of this type can be quickly and inexpensively developed to assess and optimize CT protocols for specific clinical applications.

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“…Correct identification of the prostatic arteries is necessary to avoid untargeted ischemia to the bladder, rectum, anus, or corpus cavernosum [23]. Six cases of bladder ischemia were reported; of which two were transient, and four needed minor surgery, such as resection of a small area of necrosis.…”

Section: S M Schreuder Et Al: Prostatic Arterial Embolization For mentioning

confidence: 99%

The Role of Prostatic Arterial Embolization in Patients with Benign Prostatic Hyperplasia: A Systematic Review

Schreuder

Scholtens

Reekers

et al. 2014

Cardiovasc Intervent Radiol

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Purpose This study was designed to summarize the evidence on clinical outcomes and complications of prostatic arterial embolization (PAE) in patients with benign prostatic hyperplasia (BPH). Methods We searched Medline and Embase for PAE trials of patients with BPH upto November 2013. Two reviewers independently checked the inclusion and exclusion criteria and performed data extraction of study characteristics, quantitative and qualitative outcomes, and complications. Results The search yielded 562 studies, of which 9 articles with 706 patients were included. In these 9 articles, there was a possible overlap of data and the quality of 8 studies was assessed as poor. All patients had moderate-tosevere, lower urinary tract symptoms (LUTS). The mean age ranged from 63.4-74.1 years. After embolization, a decrease of the prostate volume (PV) and post void residual (PVR) was seen mainly in the first month with a further decrease up to 12 months, increasing afterwards. The prostate specific antigen (PSA) decreased up to 3 months after PAE, increasing afterwards. The peak urinary flow (Qmax) increased mainly the first month and decreased after 30 months. The international prostate symptom score (IPSS) and quality of life-related symptoms (QOL) improved mainly during the first month, with a further improvement up to 30 months. No deterioration of the international index of erectile function (IIEF) was seen after PAE. The PAE procedure seems safe. Conclusions Although the number of studies was small, qualitatively poor, and with overlap of patients, the initial clinical outcomes as reported up to 12 months seem positive and the procedure seems safe.

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Radiological Anatomy of Prostatic Arteries

Cited by 76 publications

References 9 publications

Benign Prostatic Hyperplasia: Cone-Beam CT in Conjunction with DSA for Identifying Prostatic Arterial Anatomy

Benign Prostatic Hyperplasia: Cone-Beam CT in Conjunction with DSA for Identifying Prostatic Arterial Anatomy

Three‐dimensional printing CT‐derived objects with controllable radiopacity

The Role of Prostatic Arterial Embolization in Patients with Benign Prostatic Hyperplasia: A Systematic Review

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