Evaluation of Vessel Tracking Software for Prostatic Artery Embolization

Purpose: To evaluate Vessel Tracking software for determining the prostatic arteries feeding the prostate gland during prostatic artery embolization (PAE) using Conebeam-CT (CBCT). Materials and Methods: EmboGuide is a software developed to assist interventional radiologists in performing embolization of hypervascular tumors in the liver. In this study, a single-center retrospective image collection of 120 intraprocedural CBCT of 60 patients with benign prostatic hyperplasia treated using PAE between May 2017 and January 2019 was evaluated. All patients received 1 intraprocedural CBCT per side for evaluation of vessel anatomy. The “reference standard” of the vascular anatomy was defined by segmentation of the prostatic gland and marking of the prostatic artery in conjunction with pre-embolization DSA series. The datasets were then anonymized. Three interventional radiologists with experience in PAE from different centers reviewed the images and used the automatic feeder detection to determine the prostatic artery. Finally, two clinical experts compared the feeding vessels indicated in the “reference standard” and those identified by the readers. Objectives of the study were to evaluate the clinical performance of the software based on sensitivity and the agreement between interventional radiologists. Results: Sensitivity was estimated as 0.968 with a 90% confidence interval. Overall agreement was estimated as 0.801 with a 90% confidence interval. On both objectives (Sensitivity and Agreement), specifications were met. Conclusions: The results of this study suggest that EmboGuide can be used to determine the prostate arteries in PAE. The findings could be used to expand the intended use of EmboGuide to include PAE. Graphical Abstract: (Figure presented.)