Jaepung Han 1, Sunghoon Jeon 2, Byungjin Kim 3, Sojin Kim 1, Jiwoon Park 1, Uhjin Kim 1, Jinhwa Chang 4, Sang‐Hwan Hyun 5, Dongwoo Chang 1,✉, Namsoon Lee 1,✉
Background
Prostatic carcinoma in male dogs is a highly aggressive malignancy with a poor prognosis, limited effective treatments, and substantial metastatic potential. Prostatic artery embolization (PAE) has been proposed as a novel minimally invasive therapy. This study aimed to assess the anatomical characteristics of the canine prostatic artery using computed tomography angiography (CTA) and to develop a three-dimensional (3D)-printed model of prostate cancer for PAE simulation.
Methods
This retrospective, multicenter study analyzed CTA data from 51 dogs (37 controls, 14 with prostate cancer). The anatomical origin, diameter, and variation of the prostatic artery were assessed. A representative case was used to construct a 3D-printed silicone model simulating pelvic arterial anatomy and prostate cancer, which was then used to perform PAE under fluoroscopic guidance. Vessel diameters were correlated with body weight, and prostatic artery diameters were normalized to the aortic diameter for comparison between groups.
Results
CTA revealed that 98% of prostatic arteries originated from the internal pudendal artery. Body weight positively correlated with arterial diameters. Prostate cancer dogs had significantly larger normalized prostatic artery diameters than controls. In cases with bladder invasion, the caudal vesical and umbilical arteries also served as tumor-feeding vessels. The 3D-printed model allowed successful simulation of catheter-based embolization, verifying feasibility for training and planning purposes.
Limitations
The study had a limited sample size, especially in the cancer group, reducing statistical power. Variability in CTA protocols and the challenge of visualizing tortuous small vessels were noted. The 3D model had limitations in flexibility and realism due to silicone properties, impacting catheter navigation.
Conclusions
CTA is valuable for characterizing prostatic artery anatomy in dogs and planning PAE. The 3D-printed prostate cancer model effectively simulated PAE and may enhance clinician training and procedural planning. Further refinement of model materials and expansion of anatomical variants in model design are warranted for broader application.
Selection training for the prostatic artery using the three-dimensional printed prostate cancer model and simulator under contrast-enhanced fluoroscopy. A, Internal iliac artery selection using a 0.35-inch guidewire and the 5 Fr catheter. B, E, Prostatic artery selection using the microwire-microcatheter combination. C, F, Nontarget selection to the caudal vesical artery. D, Contrast media was injected at the level of the distal aorta. In the ventrodorsal view, the prostatic artery is not identified as it overlaps with other structures. Since the prostatic artery and prostate, the caudal vesical artery, and the bladder are connected, the success of selection can be evaluated through the flow of contrast agents. The arrowhead indicates the tip of the catheter, and the arrow indicates the tip of the microcatheter in the fluoroscopy images. A–C, The head is toward the left of the images. D–F, The head is toward the top of the images. IIA, internal iliac artery; CVA, caudal vesical artery; PA, prostatic artery; UB, urinary bladder; P, prostate.
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