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Accuracy of transrectal ultrasonography to evaluate pathologic prostate weight: correlation with various prostate
Marc Bienz1, Pierre-Alain Hueber1, Naif Al-Hathal1
1Division of Urology, Department of Surgery, Montreal University Hospital Center, Montreal, Quebec, Canada.
Urology
|July 1, 2014
Summary
Transrectal ultrasonography (TRUS) using the prolate ellipsoid formula is more accurate for larger prostates. This prostate imaging technique shows limitations for smaller glands, impacting treatment planning.
Area of Science:
- Urology
- Medical Imaging
- Surgical Planning
Background:
- Accurate prostate size estimation is crucial for surgical planning in robotic-assisted radical prostatectomy.
- Transrectal ultrasonography (TRUS) with the prolate ellipsoid formula is a common method for preoperative prostate sizing.
- The accuracy of TRUS for prostate size measurement may vary depending on the gland's dimensions.
Purpose of the Study:
- To evaluate the accuracy of transrectal ultrasonography (TRUS) in measuring prostate size before robotic-assisted radical prostatectomy.
- To assess the correlation between TRUS-estimated prostate size and postoperative specimen weight across different prostate size groups.
- To determine the reliability of the prolate ellipsoid formula for prostate volume estimation in various size categories.
Main Methods:
- Collected preoperative prostate size data from TRUS and postoperative specimen weights from 440 patients undergoing robotic-assisted radical prostatectomy.
- Categorized patients into groups based on preoperative prostate size: <30g, 30-60g, 60-80g, and ≥80g.
- Analyzed the mean absolute percentage of error and mean percentage of error to assess accuracy and systematic bias, correlating measurements within each size group.
Main Results:
- TRUS accuracy demonstrated a size-dependent trend, with improved precision for larger prostates.
- Mean absolute percentage of error was 38.64% (<30g), 21.33% (30-60g), 13.23% (60-80g), and 14.96% (≥80g).
- Correlation (r-coefficient) between TRUS and specimen weight strengthened with increasing prostate size (0.174 to 0.839), with smaller glands underestimated and larger glands (≥80g) potentially overestimated.
Conclusions:
- The prolate ellipsoid formula's accuracy for TRUS prostate size estimation is variable and size-dependent.
- While effective for larger prostates, TRUS exhibits limitations in accurately measuring smaller prostate glands.
- These findings necessitate consideration of TRUS accuracy limitations when planning treatments like transurethral incision of the prostate and brachytherapy.
