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Comparative Study
. 2020 Jan 31:18:eAO4662.
doi: 10.31744/einstein_journal/2020AO4662. eCollection 2020.

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

[Article in English, Portuguese]
Tatiana Martins  1   2 , Thais Caldara Mussi  1 , Ronaldo Hueb Baroni  1
Affiliations
Comparative Study

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

[Article in English, Portuguese]
Tatiana Martins et al. Einstein (Sao Paulo). .

Abstract
in English, Portuguese

Objective: To assess accuracy of multiparametric magnetic resonance of the prostate to estimate gland volume, comparing the results with transrectal ultrasound and surgical specimen.

Methods: A retrospective study of 85 patients who underwent multiparametric magnetic resonance and transrectal ultrasound (for fusion image-guided biopsy) before radical prostatectomy. Prostate measurements were obtained from magnetic resonance axial and sagittal T2-weighted images and ultrasound; the prostate volume was determined using the ellipsoid formula. The results were compared with the surgical specimen weight. Maximum interval between multiparametric magnetic resonance imaging, transrectal ultrasound, and prostatectomy was 6 months.

Results: The prostate volume measured by multiparametric magnetic resonance imaging was 18-157cm3 (mean of 49.9cm3) and by transrectal ultrasound, 22-165cm3 (mean of 54.9cm3); the surgical specimen weight was 20-154g (mean of 48.6g), with no statistical differences. Based on the values obtained from imaging examinations, the prostate volume obtained was very close to the real prostatic weight, and the measures by multiparametric magnetic resonance were slightly more precise.

Conclusion: Prostate volume measured by multiparametric magnetic resonance imaging and transrectal ultrasound showed similar values, and excellent agreement with real prostate weight of the surgical specimens. Prostate volume measured by magnetic resonance has been increasingly used in the clinical practice, and its value enables appropriate therapeutic planning and control of patients.

Objetivo: Avaliar a acurácia da ressonância magnética multiparamétrica da próstata para estimativa do volume da glândula, comparando seus resultados com a ultrassonografia transretal e correlacionando com o volume obtido da peça cirúrgica.

Métodos: Estudo retrospectivo incluindo 85 pacientes submetidos à ressonância magnética e, posteriormente, à ultrassonografia transretal (para orientação de biópsia com fusão de imagens) e, a seguir, à prostatectomia radical. As dimensões prostáticas foram obtidas na ressonância a partir das imagens nos planos axial e sagital em sequências ponderadas em T2 e, assim como na ultrassonografia, o volume foi calculado a partir do método da elipsoide. Os valores foram comparados com o peso prostático pós-cirúrgico. O intervalo máximo entre a ressonância e ultrassonografia e prostatectomia foi de 6 meses.

Resultados: O volume prostático obtido por ressonância magnética foi de 18 a 157cm3(média de 49,9cm3); pela ultrassonografia transretal, foi de 22 a 165cm3(média de 54,9cm3); e o peso da peça cirúrgica foi de 20 a 154g (média de 48,6g), sem diferenças estatísticas. A partir do valor obtido por esses métodos de imagem, provou-se que o volume prostático obtido aproximou-se bastante do peso real da próstata, com discreta maior precisão das medidas obtidas por ressonância magnética multiparamétrica.

Conclusão: As medidas do volume prostático adquiridas pela ressonância magnética e pela ultrassonografia transretal são semelhantes entre si, com excelente concordância com os pesos reais das próstatas obtidos das peças cirúrgicas. A avaliação desse dado, a partir da ressonância, método cada vez mais utilizado na prática clínica, permite o adequado planejamento terapêutico e o controle dos pacientes.

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Conflict of interest statement

Conflict of interest: none.

Figures

Figure 1
Figure 1. Measurements of the prostate by magnetic resonance imaging and ultrasonography on longitudinal and transverse planes
MRI: magnetic resonance imaging; TRUS: transrectal ultrasonography.
Figure 2
Figure 2. Patients included in the study
MRI: magnetic resonance imaging; US: ultrasonography; Bx: biopsy.
Figure 3
Figure 3. Evaluation of agreement between the prostatic weight values obtained by different methods. (A) Weights obtained by prostatectomy x magnetic resonance imaging; (B) By prostatectomy x ultrasonography; (C) By magnetic resonance imaging x ultrasonography
MRI: magnetic resonance imaging; TRUS: transrectal ultrasonography.
Figure 4
Figure 4. Bland-Altman graphs. (A) Correlation between prostatic weightalues obtained by ultrasonography and surgical specimen; (B) By magnetic resonance imaging and surgical specimen; (C) By magnetic resonance imaging and ultrasonography
Figura 1
Figura 1. Medidas da próstata por ressonância magnética e ultrassonografia nos planos longitudinal e transverso
RM: ressonância magnética; USTR: ultrassonografia transretal.
Figura 2
Figura 2. Pacientes incluídos no estudo
RM: ressonância magnética; US: ultrassonografia; BX: biópsia.
Figura 3
Figura 3. Avaliação da concordância entre os valores dos pesos prostáticos obtidos por diferentes métodos. (A) Pesos obtidos por prostatectomia x ressonância magnética; (B) Por prostatectomia x ultrassonografia; (C) Por ressonância magnética x ultrassonografia
RM: ressonância magnética; US: ultrassonografia.
Figura 4
Figura 4. Gráficos de Bland-Altman. (A) Correlação entre os valores dos pesos prostáticos obtidos por ultrassonografia e peça cirúrgica; (B) Por ressonância magnética e peça cirúrgica; (C) Por ressonância magnética e ultrassonografia
RM: ressonância magnética; US: ultrassonografia.
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