Skip Navigation LinksHome > July/August 2013 - Volume 37 - Issue 4 > Prostate Volumetric Assessment by Magnetic Resonance Imaging...
Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e318296af5f
Abdominal Imaging

Prostate Volumetric Assessment by Magnetic Resonance Imaging and Transrectal Ultrasound: Impact of Variation in Calculated Prostate-Specific Antigen Density on Patient Eligibility for Active Surveillance Program

Dianat, Seyed Saeid MD*; Rancier Ruiz, Ramiro M. MD; Bonekamp, David MD, PhD*; Carter, H. Ballentine MD; Macura, Katarzyna J. MD, PhD*‡

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Abstract

Objective

The objective of this study was to investigate impact of prostate volume variations on prostate-specific antigen density (PSAD) and patient eligibility for active surveillance (AS).

Methods

Prostate volume and PSAD were calculated for 46 patients with prostate cancer in AS who underwent prostate magnetic resonance imaging and transrectal ultrasound (TRUS). Manual method and 2 semiautomated methods for prostate segmentation (3D-SLICER and OsiriX) were used for MR volumetry.

Results

Magnetic resonance volumetric methods showed very good agreement (intraclass correlation coefficient, 0.98). The concordance correlation coefficient was higher among MR volumetry methods (0.971–0.998) than between TRUS and MR volumetry (0.849–0.863). The variation in PSAD estimated by TRUS versus magnetic resonance imaging was higher in large prostates (r = 0.327, P = 0.027). Transrectal ultrasonography volumetry may improperly classify 20% of patients as eligible for AS with PSAD greater than 0.15 threshold.

Conclusions

Although clinically used TRUS reliably estimates PSAD, it may misclassify some patients who are not eligible for AS based on PSAD criteria. Magnetic resonance–based volumetry should be considered for a more reliable PSAD calculation.

Copyright © 2013 by Lippincott Williams & Wilkins

  

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