How Accurately Can Prostate Gland Imaging Measure the Prostate Gland Volume? Results of a Systematic Review

Abstract

Aim. The measurement of the volume of the prostate gland can have an influence on many clinical decisions. Various imaging methods have been used to measure it. Our aim was to conduct the first systematic review of their accuracy. Methods. The literature describing the accuracy of imaging methods for measuring the prostate gland volume was systematically reviewed. Articles were included if they compared volume measurements obtained by medical imaging with a reference volume measurement obtained after removal of the gland by radical prostatectomy. Correlation and concordance statistics were summarised. Results. 28 articles describing 7768 patients were identified. The imaging methods were ultrasound, computed tomography, and magnetic resonance imaging (US, CT, and MRI). Wide variations were noted but most articles about US and CT provided correlation coefficients that lay between 0.70 and 0.90, while those describing MRI seemed slightly more accurate at 0.80-0.96. When concordance was reported, it was similar; over- and underestimation of the prostate were variably reported. Most studies showed evidence of at least moderate bias and the quality of the studies was highly variable. Discussion. The reported correlations were moderate to high in strength indicating that imaging is sufficiently accurate when quantitative measurements of prostate gland volume are required. MRI was slightly more accurate than the other methods.

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

“…Additionally, it shows good reproducibility and is used several studies to evaluate prostatic volume, as was recently shown in a published meta-analysis. (12) The median prostatic weight based on surgical specimens obtained in our study was 42g, which is in correspondence with that found in other studies, such as by Mayer et al, which demonstrated a median weight of 47.6g, and Badani et al, of 49.9g. (13,14) It is possible that, in our study, this value was a little lower due to the fact that sample had many patients under 60 years of age (n=24; 28%), which could justify a lower prostatic weight due to smaller lower volume in the transition zone.…”

Reducing Unnecessary Prostate Multiparametric Magnetic Resonance Imaging by Using Clinical Parameters to Predict Negative and Indeterminate Findings

“…However, TRUS of the prostate is a routine, low cost procedure in urology clinics which can reliably assess prostate volume. 16 Therefore, accurate PSAd estimates can be obtained before mpMRI without altering the clinical workflow. Applying decision thresholds of 0.078 ng/ml 2 for PSAd and 0.082 for the threshold probability of the multivariate model would have resulted in a net reduction of 25% and 29% of prostate mpMRI scans, respectively.…”

“…This is unlike TRUS, which is considered a routine prebiopsy procedure which can reliably estimate prostate volume. 16 A recent review article concluded that sufficiently accurate prostate volume measurements were obtained by the 2 imaging modalities with MRI being only slightly more accurate. 16…”

“…Prostate volume was measured on mpMRI using the exact prolate ellipsoid formula, volume [ length  width  height  p/6. 16…”

The ‘Urological Stethoscope’: an essential aide for the modern benign prostatic hyperplasia specialist?

“…Both DRE and PSA measurement have some utility in estimating prostate volume but they are not accurate enough . Conversely, TRUS measurement of prostate volume has been shown to correlate well with radical prostatectomy specimens . This is important because a larger volume prostate has been linked with increased blood loss .…”