Prostate volume measurement by multiparametric magnetic resonance and transrectal ultrasound: comparison with surgical specimen weight

Martins, Tatiana; Mussi, Thais C.; Baroni, Ronaldo Hueb

doi:10.31744/einstein_journal/2020ao4662

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…Foi encontrada correlação entre o peso prostático verificado pela ultrassonografia transretal e o PSA total pré-operatório dos pacientes (p=0,0195 e r=0,22), porém com força inferior à correlação positiva encontrada entre o primeiro e o volume prostático estimado pela RNM pélvica (p=0,0001 e r=0,71), situação similar à encontrada na literatura (MARTINS et al, 2020).…”

Section: Discussionunclassified

Análise comparativa entre resultados de exames complementares e peça cirúrgica final de pacientes submetidos a prostatovesiculectomia radical

Levatti¹,

Monteiro²,

Buiar³

et al. 2023

Braz. J. Hea. Rev.

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Introdução: A próstata é a maior glândula acessória genital masculina e, uma vez acometida por uma neoplasia, pode desencadear um dos mais prevalentes cânceres entre os homens. Para fins de diagnóstico preciso desta condição e definição de prognóstico, é fundamental a realização de exames complementares, como laboratoriais, de imagem - em especial a ressonância nuclear magnética multiparamétrica (RNM) de pelve - além de anatomopatológicos, de biópsia prostática e peça anatômica cirúrgica final, visto que tais exames verificam importantes fatores determinantes da gravidade da doença, como PI-RADS e Escore de Gleason, de modo a beneficiar a estratificação do risco de cada paciente e guiar o médico assistente para o tratamento mais adequado. Objetivo: Descrever os principais achados de exames de imagem correlatos ao câncer de próstata, com enfoque na RNM pélvica, além de resultados de biópsia prostática e de análise anatomopatológica de peça cirúrgica final relativas aos pacientes submetidos a prostatovesiculectomia radical em um hospital privado de Curitiba-PR, e estabelecer comparações e associações estatísticas entre os achados, utilizando fatores determinantes de gravidade do câncer de próstata (CaP). Materiais e Métodos: Estudo observacional transversal analítico e retrospectivo, realizado com prontuários eletrônicos e exames complementares de pacientes admitidos pelo Serviço de Urologia do Hospital da Cruz Vermelha Brasileira – Filial do Paraná, de Curitiba-PR, e submetidos a prostatovesiculectomia radical no período de 01 de janeiro de 2008 a 31 de outubro de 2021. Resultados: Foram incluídos 115 prontuários no estudo, com correlações estatisticamente significativas em diversas comparações: Escore de Gleason (EG) da biópsia e PSA pré-operatório mostraram uma correlação positiva (com medianas dos EG 6: 5,49 [2,7-7,6]; EG 7: 6,04 [1,62-7,68]; EG 8-9: 7,7 [6,8-12,9] [p=0,0038]). Também houve comparação entre os EG das biópsias com as peças cirúrgicas, com o mesmo valor de EG 6 em 52,3%, em EG 7 96,4 e nos EG maiores de 7 em 93,8 (p<0,0001), subestimando o valor do tumor em todos os casos discrepantes, exceto um. A classificação de PI-RADS, quando comparada aos EG das biópsias, demonstrou que um PIRADS 3 associa-se em 95,2% dos casos a EG menor ou igual a 7, o que se observa em 89,9% dos PI-RADS 4, enquanto um PI-RADS 5 liga-se a um EG superior ou igual a 7 em 96% das ocasiões. Em pacientes com PI-RADS 3, 4 e 5 foram encontrados respectivamente 0%, 5,8% e 40% de metástase em linfonodos (p<0,0001), e invasão perineural esteve presente em 95% dos PIRADS 4 e 5, e em 66,7% dos PI-RADS 3. Este estudo também analisou relações entre invasão linfonodal e perineural e entre PI-RADS e estádio patológico do CaP. Conclusão: A RNM de pelve beneficia intensamente a determinação do prognóstico e da gravidade do câncer de próstata, haja vista ser um método diagnóstico não invasivo e provido de associações estatisticamente significativas em relação a outros fatores determinantes da gravidade desta condição.

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Section: Discussionunclassified

Análise comparativa entre resultados de exames complementares e peça cirúrgica final de pacientes submetidos a prostatovesiculectomia radical

Levatti¹,

Monteiro²,

Buiar³

et al. 2023

Braz. J. Hea. Rev.

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“…Subsequent studies confirmed that the TPV measured by TRUS is comparable with findings on multiparametric MRI and both have excellent agreement with real prostate weight of the surgical specimens. 12 , 13 However, TZV measurement on TRUS is operator dependent and its accuracy is controversial. 14 Some authors report significant discrepancies between TRUS determination of TZV when compared with enucleated adenoma weight.…”

Section: Discussionmentioning

confidence: 99%

Morphometric Analysis of Prostate Zonal Anatomy After Transurethral Resection of Prostate and Holmium Laser Enucleation of Prostate Using Magnetic Resonance Imaging: A Pilot Study

Bhat¹,

Katz²,

Acharya³

et al. 2022

Turkish Journal of Urology

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Objective: The primary purpose was to compare the completeness of adenomectomy and zonal anatomy of prostate on magnetic resonance imaging prostate after transurethral resection of prostate and Holmium enucleation of prostate. The secondary purpose was to investigate the relationship between preoperative total prostate volume and postoperative transition zone and peripheral zone volume after both procedures. Material and methods: A retrospective review of all patients who underwent transurethral resection of prostate or Holmium enucleation of prostate over 3 years (2017-2020) and had at least 1 postoperative magnetic resonance imaging prostate was performed. Volume estimations of the prostate and individual zones were performed, and statistical comparisons were made to evaluate morphometric changes between the 2 procedures. Results: A total of 9 patients (mean age, 71.8 years) underwent transurethral resection of prostate and 12 patients (mean age, 66.9 years) underwent Holmium enucleation of prostate. The median pre-operative prostate volume in the Holmium enucleation of prostate group was higher than the transurethral resection of prostate group (101.5 g vs. 62 g; P = .102). However, there was a significant difference in the resected tissue weight favoring Holmium enucleation of prostate over transurethral resection of prostate ( P value = .004). The postoperative transition zone and peripheral zone volume as calculated by magnetic resonance imaging remained relatively constant in both procedures. The peripheral zone volume on postoperative magnetic resonance imaging was found to be independent of transition zone volume even for very large-sized prostates. Conclusion: A well-performed transurethral resection of prostate or Holmium enucleation of prostate can nearly completely eliminate the transition zone volume, irrespective of the size of the prostate as confirmed by magnetic resonance imaging prostate. Additionally, the peripheral zone volume is consistent across the entire spectrum of the prostate size.

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“…Prostate volume estimation on the basis or TRUS data was associated with the availability of these findings among all patients included into the study. In addition, recent investigations have proven that prostate volume measured by TRUS does perfectly correspond to the actual weight of a surgical specimen [14]. Ever since the prognosis and management differ according to the extent of tumor involvement, patients were categorized into localized (cT1-2N0M0, n=272), locally advanced (T3-4N0M0, T1-4N1M0, n=231) and metastatic PC (T1-4N0-1M1, n=211) groups.…”

Section: Methodsmentioning

confidence: 99%

Prostate specif c antigen density as a prognostic factor in patients with prostate cancer treated with combined hormonal radiation therapy

et al. 2022

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Purpose. To evaluate prostate specifc antigen density (PSAD) as a predictor of overall (OS) and cancerspecifc survival (CSS) in patients with prostate cancer (PC) who have undergone combined hormonal-radiation therapy.Material and Methods. In order to assess the prognostic signifcance of PSAD we retrospectively analyzed outcomes of 714 PCa patients who received combined hormonal-radiation therapy at the A.M. Granov Russian Scientifc Center of Radiology and Surgical Technologies, Ministry of Healthcare of Russia, between January 1996 and December 2016. Since the prognosis and management differ according to the extent of tumor involvement, patients were categorized into localized (n=272), locally advanced (n=231) and metastatic (n=211) PC groups. We equentially applied ROC-analysis, Kaplan-Meier product limit estimator and Cox proportional hazards model to assess the prognostic relevance and establish threshold values of PSAD that had a signifcant impact on survival rates.Results. In the localized PC group, PSAD threshold values of 0.34 ng/mL/cc and 0.36 ng/mL/cc were associated with a decrease in OS and CSS, respectively. Patients with “low” PSAD had signifcantly better OS and CSS survival rates in both uni- and multivariate analyses. In locally advanced PC group, PSAD threshold values were 0.28 ng/mL/cc and 0.63 ng/mL/cc for OS and CSS, respectively. However, exceeding the specifed values, in the locally advanced PC group, was not accompanied by a statistically signifcant decrease in survival rates. Finally, in the metastatic PC group, established PSAD threshold values were 2.25 ng/mL/cc and 2.30 ng/mL/ccfor OS and CSS, respectively. According to the results of univariate analysis, patients with “low” PSA tend to demonstrate statistically signifcant better OS and CSS rates. The results of multivariate analysis, however, failed to prove PSAD as an independent prognostic factor within the metastatic PC cohort. Conclusion. PSA density is a reliable tool for assessing survival rates in patients with localized PC who have undergone combined hormonal-radiation therapy.

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Prostate volume measurement by multiparametric magnetic resonance and transrectal ultrasound: comparison with surgical specimen weight

Cited by 7 publications

References 21 publications

Análise comparativa entre resultados de exames complementares e peça cirúrgica final de pacientes submetidos a prostatovesiculectomia radical

Análise comparativa entre resultados de exames complementares e peça cirúrgica final de pacientes submetidos a prostatovesiculectomia radical

Morphometric Analysis of Prostate Zonal Anatomy After Transurethral Resection of Prostate and Holmium Laser Enucleation of Prostate Using Magnetic Resonance Imaging: A Pilot Study

Prostate specif c antigen density as a prognostic factor in patients with prostate cancer treated with combined hormonal radiation therapy

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