Simulação de Monte Carlo para avaliação dosimétrica em procedimento de Embolização de Artéria Prostática

Abstract

This work addresses Benign Prostatic Hyperplasia (BPH) and its alternative treatment through Prostatic Artery Embolization (PAE). BPH is a condition characterized by prostate enlargement, commonly diagnosed in men over 40 years, with symptoms often associated with Lower Urinary Tract Symptoms (LUTS). PAE is a minimally invasive procedure in interventional radiology (IR), however, this approach leads to high occupational exposure for the medical staff, due to the professional’s presence inside the room and the prolonged fluoroscopy time associated. Based on this context, computational simulations were performed using the Monte Carlo Method to study radiation doses involved in PAE procedures. Typical IR scenarios were represented by simulations with varying parameters: tube voltages of 70, 80 and 90 kV; projections, posteroanterior (PA) and left anterior oblique at 35° (LAO 35); and different materials for radiation protections aprons. The highest values of the absorbed dose conversion coefficient (CC[D]) were observed in the scenario corresponding to the LAO 35 projection with a tube voltage of 90 kV. Considering this most critical condition, the most effective radiations protection apron was an apron composed of tin (55%) and tungsten (45%), achieving doses reduction of approximately 73% for the main physician and 65% for the assistant physician. It is concluded, therefore, that during PAE procedures, the use of personal protective equipment is essential, and whenever possible, image acquisition parameters should be optimized to ensure radiological protection for healthcare professionals and patients.