Prostate Volume Index Associates with a Decreased Risk of Prostate Cancer: Results of a Large Cohort of Patients Elected to a First Biopsy Set

Porcaro, Antonio Benito; Novella, Giovanni; Cacciamani, Giovanni; Marchi, Davide De; Corsi, Paolo; Luyk, Nicolò De; Bizzotto, Leonardo; Processali, Tania; Cerasuolo, Mattia; Tamanini, Irene; Cerruto, Maria Angela; Brunelli, Matteo; Siracusano, Salvatore; Artibani, Walter

doi:10.1159/000447432

Cited by 9 publications

(9 citation statements)

References 16 publications

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“…This is in line with a recent TRUS volumetry investigation of 596 cases [11] . With increasing prostate volume, specific areas may be underrepresented on systematic sampling such as lesions located anteriorly and in the apex or missed by targeted biopsies, although there is no data for targeted biopsies.…”

Section: Discussionsupporting

confidence: 91%

Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil?

Haas

Günzel²,

Miller³

et al. 2016

Urol Int

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Prostate volume in multiparametric MRI (mpMRI) is of clinical importance. For 3-Tesla mpMRI without endorectal coil, there is no distinctive standard for volume calculation. We tested the accuracy of the ellipsoid formula with planimetric volume measurements as reference and investigated the correlation of gland volume and cancer detection rate on MRI/ultrasound (MRI/US) fusion-guided biopsy. One hundred forty-three patients with findings on 3-Tesla mpMRI suspicious of cancer and subsequent MRI/US fusion-guided targeted biopsy and additional systematic biopsy were analyzed. T2-weighted images were used for measuring the prostate diameters and for planimetric volume measurement by a segmentation software. Planimetric and calculated prostate volumes were compared with clinical data. The median prostate volume was 48.1 ml (interquartile range (IQR) 36.9-62.1 ml). Volume calculated by the ellipsoid formula showed a strong concordance with planimetric volume, with a tendency to underestimate prostate volume (median volume 43.1 ml (IQR 31.2-58.8 ml); r = 0.903, p < 0.001). There was a moderate, significant inverse correlation of prostate volume to a positive biopsy result (r = -0.24, p = 0.004). The ellipsoid formula gives sufficient approximation of prostate volume on 3-Tesla mpMRI without endorectal coil. It allows a fast, valid volume calculation in prostate MRI datasets.

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Section: Discussionsupporting

confidence: 91%

Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil?

Haas

Günzel²,

Miller³

et al. 2016

Urol Int

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“…NPC was independently decreased by PVI indicating inverse association between PVI and tumor load. This finding was expected since we have previously shown that PVI associated with a decreased risk of PCA at baseline biopsies ( 7 , 13 , 14 ). So far, PVI associated with a decreased risk of PCA and decreased NPC in patients undergoing baseline biopsies indicating inverse association with tumor biology.…”

Section: Discussionsupporting

confidence: 67%

“…PVI is a pure measure since represents a ratio between volumes. We have shown that PVI represents the gradient of the regression line of TZV as a function of PZV ( 7 , 13 , 14 ). Considering the relations between PZV and TZV, PVI quartiles represent the different gradients of the regression lines between the two volumes.…”

Section: Discussionmentioning

confidence: 99%

“…In patients undergoing baseline prostate biopsies, our working group has demonstrated that PCI is inversely associated with the risk of PCA ( 6 - 12 ). Moreover, our group has also investigated the associations of prostate volume index (PVI), defined as the ratio of the volume of the central transition zone (CTZV) to the volume of the peripheral zone (PZV) of the prostate, with the risk of PCA and the outcomes have shown an inverse association ( 7 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

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Elevated prostate volume index and prostatic chronic inflammation reduce the number of positive cores at first prostate biopsy set: results in 945 consecutive patients

et al. 2020

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Objective To assess the association between prostate volume index (PVI), and prostatic chronic inflammation (PCI) as predictors of prostate cancer (PCA). PVI is the ratio between the central transition zone volume (CTZV) and the peripheral zone volume (PZV). Materials and methods Parameters evaluated included age, prostate specific antigen (PSA), total prostate volume (TPV), PSA density (PSAD), digital rectal exam (DRE), PVI, PCI and number of positive cores (NPC). All patients underwent baseline 14-core, trans-perineal random biopsies. Associations of parameters with the NPC were investigated by univariate and multivariate linear regression analysis. Results Between September 2010 to September 2017, 945 patients were evaluated. PCA was detected in 477 cases (50.7%), PCI in 205 cases (21.7%). PCA patients, compared to negative cases, were older (68.3 vs. 64.4 years) with smaller TPV (36 vs. 48.3mL) and CTZV (19.2 vs. 25.4), higher PSAD (0.24 vs. 0.15ng/mL/mL), further PVI values were lower (0.9 vs. 1.18) and biopsy cores less frequently involved by PCI (9.4% vs. 34.2%).High PVI and the presence of PCI were independent negative predictors of NPC in model I considering PSA and TVP (PVI, regression coefficient, RC -0,6; p=0.002) and PCI (RC -1,4; p <0.0001); and in model II considering PSAD (PVI:RC -0,7; p <0,0001; and PCI: RC -1,5; p <0.0001). Conclusions High PVI and the presence of PCI lowered the mean rate of NPC and is associated with less aggressive tumor biology expressed by low tumor burden. PVI can give prognostic information before planning baseline random biopsies. Confirmatory studies are required.

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“…A possible explanation is that small prostates have larger volumes of the peripheral zone and are more likely to develop more aggressive cancers; moreover, large prostates show thin peripheral zone volumes as well as sampling errors and then less likely to develop high-grade cancers. Literature investigation support this hypothesis since it has been shown that the ratio between the volume of the central zone and the volume of the peripheral have an impact on the risk of having a positive biopsy [26,27] . Our study showed that prostates having more than one BPC were more likely to have DR/P.…”

Section: Discussionmentioning

confidence: 88%

Clinical Factors of Disease Reclassification or Progression in a Contemporary Cohort of Prostate Cancer Patients Elected to Active Surveillance

Porcaro¹,

Cavicchioli²,

Mattevi³

et al. 2016

Urol Int

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Objectives: To evaluate clinical predictors of disease reclassification or progression (DR/P) in prostate cancer patients elected to active surveillance (AS). Material and Methods: Patients were assessed on the basis of DR/P criteria. Predictors of DR/P were evaluated by multivariate logistic regression and Cox proportional hazards. Results: The median DR/P free time was 16.5 months. DR/P was detected in 30 out of 84 cases (35.7%). In DR/P cases, the median prostate volume (PV) was significantly lower (34.7 vs. 42.7 ml) and the percentage of cases with 2 or 3 vs. 1 initial biopsy positive cores (BPC) was significantly higher (36.7 vs. 7.4%). The multivariate logistic regression model showed that PV (OR 0.9; p = 0.021) and initial n >1 BPC (OR 9.8; p = 0.001) were independent predictors of DR/P. By Cox multivariate proportional hazards, only n >1 BPC predicted early DR/P (hazard ratio 3.1; p = 0.003). Conclusions: In a contemporary cohort of patients elected to AS, independent factors stratifying the risk of DR/P were PV and initial BPC, which also predicted early DR/P. In patients elected to AS, the identification of risk factors of DR/P require early re-biopsy. Confirmatory studies are required.

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Prostate Volume Index Associates with a Decreased Risk of Prostate Cancer: Results of a Large Cohort of Patients Elected to a First Biopsy Set

Cited by 9 publications

References 16 publications

Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil?

Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil?

Elevated prostate volume index and prostatic chronic inflammation reduce the number of positive cores at first prostate biopsy set: results in 945 consecutive patients

Clinical Factors of Disease Reclassification or Progression in a Contemporary Cohort of Prostate Cancer Patients Elected to Active Surveillance

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