Center experience and other determinants of patient radiation exposure during prostatic artery embolization: a retrospective study in three Scandinavian centers
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Center experience and other determinants of patient radiation exposure during prostatic artery embolization : a retrospective study in three Scandinavian centers. / Svarc, Petra; Hagen, Thijs; Waltenburg, Hanne; Andersson, Christian; Bläckberg, Mats; Baco, Eduard; Taudorf, Mikkel; Røder, Martin Andreas; Lindgren, Hans; Kløw, Nils Einar; Lönn, Lars Birger.
In: European Radiology, Vol. 32, 2022, p. 2404–2413.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Center experience and other determinants of patient radiation exposure during prostatic artery embolization
T2 - a retrospective study in three Scandinavian centers
AU - Svarc, Petra
AU - Hagen, Thijs
AU - Waltenburg, Hanne
AU - Andersson, Christian
AU - Bläckberg, Mats
AU - Baco, Eduard
AU - Taudorf, Mikkel
AU - Røder, Martin Andreas
AU - Lindgren, Hans
AU - Kløw, Nils Einar
AU - Lönn, Lars Birger
N1 - Publisher Copyright: © 2021, European Society of Radiology.
PY - 2022
Y1 - 2022
N2 - Objectives: To evaluate the effects of center experience and a variety of patient- and procedure-related factors on patient radiation exposure during prostatic artery embolization (PAE) in three Scandinavian centers with different PAE protocols and levels of experience. Understanding factors that influence radiation exposure is crucial in effective patient selection and procedural planning. Methods: Data were collected retrospectively for 352 consecutive PAE procedures from January 2015 to June 2020 at the three centers. Dose area product (DAP (Gy·cm2)) was selected as the primary outcome measure of radiation exposure. Multiple patient- and procedure-related explanatory variables were collected and correlated with the outcome variable. A multiple linear regression model was built to determine significant predictors of increased or decreased radiation exposure as reflected by DAP. Results: There was considerable variation in DAP between the centers. Intended unilateral PAE (p = 0.03) and each 10 additional patients treated (p = 0.02) were significant predictors of decreased DAP. Conversely, increased patient body mass index (BMI, p < 0.001), fluoroscopy time (p < 0.001), and number of digital subtraction angiography (DSA) acquisitions (p < 0.001) were significant predictors of increased DAP. Conclusions: To minimize patient radiation exposure during PAE radiologists may, in collaboration with clinicians, consider unilateral embolization, pre-interventional CTA for procedure planning, using predominantly anteroposterior (AP) projections, and limiting the use of cone-beam CT (CBCT) and fluoroscopy. Key Points: • Growing center experience and intended unilateral embolization decrease patient radiation exposure during prostatic artery embolization. • Patient BMI, fluoroscopy time, and number of DSA acquisitions are associated with increased DAP during procedures. • Large variation in radiation exposure between the centers may reflect the use of CTA before and CBCT during the procedure.
AB - Objectives: To evaluate the effects of center experience and a variety of patient- and procedure-related factors on patient radiation exposure during prostatic artery embolization (PAE) in three Scandinavian centers with different PAE protocols and levels of experience. Understanding factors that influence radiation exposure is crucial in effective patient selection and procedural planning. Methods: Data were collected retrospectively for 352 consecutive PAE procedures from January 2015 to June 2020 at the three centers. Dose area product (DAP (Gy·cm2)) was selected as the primary outcome measure of radiation exposure. Multiple patient- and procedure-related explanatory variables were collected and correlated with the outcome variable. A multiple linear regression model was built to determine significant predictors of increased or decreased radiation exposure as reflected by DAP. Results: There was considerable variation in DAP between the centers. Intended unilateral PAE (p = 0.03) and each 10 additional patients treated (p = 0.02) were significant predictors of decreased DAP. Conversely, increased patient body mass index (BMI, p < 0.001), fluoroscopy time (p < 0.001), and number of digital subtraction angiography (DSA) acquisitions (p < 0.001) were significant predictors of increased DAP. Conclusions: To minimize patient radiation exposure during PAE radiologists may, in collaboration with clinicians, consider unilateral embolization, pre-interventional CTA for procedure planning, using predominantly anteroposterior (AP) projections, and limiting the use of cone-beam CT (CBCT) and fluoroscopy. Key Points: • Growing center experience and intended unilateral embolization decrease patient radiation exposure during prostatic artery embolization. • Patient BMI, fluoroscopy time, and number of DSA acquisitions are associated with increased DAP during procedures. • Large variation in radiation exposure between the centers may reflect the use of CTA before and CBCT during the procedure.
KW - Angiography, digital subtraction
KW - Embolization, therapeutic
KW - Fluoroscopy
KW - Prostatic hyperplasia
KW - Radiation exposure
U2 - 10.1007/s00330-021-08351-5
DO - 10.1007/s00330-021-08351-5
M3 - Journal article
C2 - 34786614
AN - SCOPUS:85119103538
VL - 32
SP - 2404
EP - 2413
JO - European Radiology
JF - European Radiology
SN - 0938-7994
ER -
ID: 288199735