To evaluate the accuracy of transrectal ultrasound (TRUS), computed tomography (CT), and magnetic resonance imaging (MRI) compared to the reference standard of the post-surgical anatomic prostatic weight (APW).
A total of 349 patients from two institutions were included. The CT and MRI dimensions, and TRUS-reported prostate volumes (PV) were obtained. The prolate ellipsoid formula was used to calculate PV. Cross-sectional measurements were evaluated and compared to the reported post-surgical pathology measurements and calculated pathology volume (path PV). A basic statistical analysis was performed using the Pearson correlation, Bland-Altman analysis, and Passing-Bablok regression.
A total of 198 patients were included in the MRI group, 118 in the CT group, 295 in the TRUS group, and 51 in the all-inclusive common cohort. The MRI PV demonstrated a good to excellent correlation with the APW (r=0.79). The CT PV demonstrated a good correlation with APW (r=0.78). The TRUS PV showed a correlation with APW (r=0.67). The correlations identified in each individual group held true in the common cohort as well. The path PV showed an excellent correlation with APW (r=0.87), followed by MRI PV (r=0.81), then CT PV (r=0.73), and lastly TRUS PV (r=0.71).
MRI and CT are equally effective in assessing the PV, and they can be readily utilized to guide the benign prostatic hyperplasia (BPH) management without repeating in-office TRUS. This is not only cost-effective, but also eliminates patient anxiety and discomfort.
Turkish journal of urology. 2020 Jan 01*** epublish ***
Vaishnavi Narayanamurthy, Kirtishri Mishra, Amr Mahran, Laura Bukavina, Lee Ponsky, Ehud Gnessin
Case Western Reserve University School of Medicine, Cleveland, OH, USA., University Hospitals, Cleveland Medical Center, Cleveland, OH, USA.