Novel ultrasound-based volume estimation of prostatic benign enlargement to improve decision-making on surgical approach

Dekalo, Snir; Savin, Ziv; Schreter, Eran; Marom, Ron; Bar-Yosef, Yuval; Yossepowitch, Ofer; Sofer, Mario

doi:10.1177/1756287221993301

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…As for tools for assessment, previous literature demonstrated that although both transabdominal and transrectal ultrasounds could provide information to predict the resected weight of prostate, the latter could provide the closer approximation. 12 In our multivariable logit model, assessment of prostatic volume via transrectal ultrasound could also be associated with iPCa.…”

Section: Discussionmentioning

confidence: 83%

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Incidental Prostate Cancer from Prostate with Benign Biopsies: A Predictive and Survival Analysis from Cohort Study

Yang¹,

Lin²,

WC³

et al. 2022

IJGM

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Purpose This cohort was to evaluate incidental prostate cancer (iPCa) from men with preoperative benign biopsies and demonstrate their outcomes under different managements. Patients and Methods Between 2015 and 2017, we analyzed the risk factors having iPCa from surgical specimens from men provided with benign preoperative biopsies of their prostates. Furthermore, we compared the survival outcomes according to the different managements after iPCa was diagnosed. Receiver operating characteristic (ROC) curve was utilized to find the best thresholds. Univariable and multivariable nested logit regression were performed to estimate the effect size of different independent variables. Odds ratio (OR) was expressed with 95% confidence interval, and the alpha level was 5%. Results In 295 men we enrolled, there were 57 (19%) men having iPCa from surgical specimens. In univariable logit regression, we found significant variables of age, PSA, prostatic volume, PSA velocity ≥ 0.75 ng/mL/year for 3 years, taking 5α reductase inhibitors, abnormal digital rectal examination, cores of biopsy and surgical methods. In multivariable model, PSA was the strongest variable predicting iPCa (OR 3.81 [2.04–7.07]; Wald: 17.75; p < 0.001). In ROC curve, the best threshold was 9.025 ng/mL (area under curve: 0.95; sensitivity: 0.947; specificity: 0.866). In Kaplan–Meier curve of 27.89-month follow-up, robot-assisted simple prostatectomy (RASP) can provide similar PSA progression-free period as robot-assisted radical prostatectomy (RARP) following transurethral surgeries in organ-confined cancer (Log rank test, p = 0.293), and both of them were better than external-beam radiation therapy (RT) following transurethral surgeries (Log rank test, p < 0.001). Conclusion PSA was the strongest variable to predict iPCa out of prostate with preoperative benign biopsies. RASP was parallel to RARP following transurethral surgeries in organ-confined cancer in the short term.

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Section: Discussionmentioning

confidence: 83%

“…Systematic biopsies were done via transrectal ultrasound-guided fashion and prostatic volume was measured by transrectal ultrasonography (height ×width ×length × 0.52) before surgeries. 12 Information regarding family histories of prostate cancer was collected from grandfather to their brothers.…”

Section: Methodsmentioning

confidence: 99%

Incidental Prostate Cancer from Prostate with Benign Biopsies: A Predictive and Survival Analysis from Cohort Study

Yang¹,

Lin²,

WC³

et al. 2022

IJGM

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“…Four studies claimed otherwise [24], [29], [40], [41]. One study stated that SUS-derived PV estimates signi cantly over-estimated specimen weight [29], while another claimed SUS-derived PV estimates were signi cantly different to specimen values [24].…”

Section: Sus-based Pv Accuracymentioning

confidence: 99%

“…suggests that the constant value of the geometric model may not be the most accurate formulation, and that instead a "variable constant"" (possibly a function of the prostate size) should be used. Such a formula has been presented, where the "adjusted prostate volume" is a function of patient age and the calculated prolate ellipsoid volume of the prostate [24].…”

Section: 09cmmentioning

confidence: 99%

Surface-Based Ultrasound Scans for the Screening of Prostate Cancer

Bennett,

Tse,

Barrett

2023

Preprint

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Surface-based ultrasound systems have shown a remarkable improvement over the years, both in enhanced image quality, ease-of-use, and reduction in overall system size. Their ability to image organs non-invasively make them a prime technology for the diagnosis and monitoring of various diseases and conditions. One such potential use case is the screening of prostate cancer using prostate-specific antigen density (combining prostate-specific antigen values with prostate volumes). Current literature predominantly focuses on prostate volume estimation techniques that make use of magnetic resonance- or transrectal ultrasound-imaging, while surface-based techniques are largely skipped over. If a reliable surface-based ultrasound prostate cancer screening method can be introduced, a portion of patients may be able to forgo unnecessary magnetic resonance- or transrectal ultrasound-scans. This would save healthcare systems both time and resources as such a screening procedure could potentially be introduced into standard primary care settings with portable point-of-care ultrasound systems available at a fraction of the cost of their larger hospital counterparts. This review considers whether published literature suggests it is possible to use surface-based ultrasound devices in the calculation of prostate volume with high enough efficacy to be used in prostate cancer screening in primary health care, prior to secondary referral.

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“…Based upon pathologic specimens during an open prostatectomy, an AUS prostate volume-adjusting formula was calculated to improve the accuracy of AUS volume determinations [6]. Considering the global trend toward shifting from open enucleation to transurethral enucleation, this is a validation study to investigate the accuracy of that formula in predicting prostate adenoma volumes and in improving preoperative planning before transurethral laser enucleations of BPH.…”

Section: Introductionmentioning

confidence: 99%

Improving Prostatic Preoperative Volume Estimation and Planning before Laser Enucleation

Savin

Dekalo²,

Herzberg³

et al. 2022

JPM

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We aimed to validate a formula for improving the estimation of prostatic volume by abdominal ultrasound (AUS) prior to transurethral laser enucleation. A total of 293 patients treated for benign prostate hyperplasia (BPH) by laser enucleation from 2019–2022 were included. The preoperative AUS volume was adjusted by the formula 1.082 × Age + 0.523 × AUS − 53.845, which was based on specimens retrieved by suprapubic prostatectomy. The results were compared to the weight of the tissue removed by laser enucleation as determined by the intraclass correlation coefficient test (ICC). The potential impact of preoperative planning on operating time was calculated. The ICC between the adjusted volumes and the enucleated tissue weights was 0.86 (p < 0.001). The adjusted volume was more accurate than the AUS volume (weight-to-volume ratio of 0.84 vs. 0.7, p < 0.001) and even more precise for prostates weighing >80 g. The median operating time was 90 min. The adjusted volume estimation resulted in an overall shorter expected preoperative operating time by a median of 21 min (24%) and by a median of 40 min in prostates weighing >80 g. The adjustment formula accurately predicts prostate volume before laser enucleation procedures and may significantly improve preoperative planning, the matching of a surgeon’s level of expertise, and the management of patients’ expectations.

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Novel ultrasound-based volume estimation of prostatic benign enlargement to improve decision-making on surgical approach

Cited by 6 publications

References 22 publications

Incidental Prostate Cancer from Prostate with Benign Biopsies: A Predictive and Survival Analysis from Cohort Study

Incidental Prostate Cancer from Prostate with Benign Biopsies: A Predictive and Survival Analysis from Cohort Study

Surface-Based Ultrasound Scans for the Screening of Prostate Cancer

Improving Prostatic Preoperative Volume Estimation and Planning before Laser Enucleation

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