Abstract No. 398 Patient Radiation Dose and Related Adverse Events in Prostatic Artery Embolization: Outcomes for 1345 Patients from a 10-Center Multi-National Study

To quantify radiation dose and associated risks for prostatic artery embolization (PAE) when performed by experienced operators at high-volume centers. Fluoroscopy time (FT), cumulative air kerma (CAK), and field of view area (FoV) data were retrospectively collected for 1387 PAE procedures performed on fixed interventional fluoroscopic units from January 2014 to January 2022, by operators with >10 years of PAE experience from 10 high-volume centers ( >75 procedures) worldwide. CAK, FT, and kerma-area product (KAP) were plotted against sequential procedure number for each site. Piecewise linear segmented regression identified optimal curve breakpoints as cutoffs to exclude operator learning curve procedures that might skew data1. Mean/median effective dose (ED) were calculated and radiation-related adverse events tabulated for all included procedures. Excess relative risk of cancer-related death from PAE was calculated using the International Commission on Radiological Protection extrapolation model of 4.1-4.8%/Sv of ED2. 42 learning curve procedures from 1 center were excluded. Radiation dose data were analyzed for 1345 PAE procedures (Table 398.1). Mean values across all centers were FT=40.2±12.0 min, CAK=1315±510 mGy, KAP=194±75 Gy×cm2, and ED=21.4±8.2 mSv. Median overall ED was 18.0 mSv, with no reported 90-day deterministic-type adverse events. Calculated median excess relative risk of cancer-related death from PAE was 0.08–0.09%. PAE performed by experienced operators at high-volume centers resulted in low patient radiation doses with no deterministic adverse events and minimal excess risk for stochastic events.