Quantitative Analysis of the Accuracy of Linear Array Transrectal Ultrasound in Measurement of the Prostate

Yip, Yum Lina; Chan, C.W.; Li, C. K.; Chu, Vanessa; Lau, Mei-ling

doi:10.1111/j.1464-410x.1991.tb15074.x

Cited by 11 publications

(4 citation statements)

References 6 publications

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“…These authors, using the resected prostate as the "gold standard", found that their length measurement had a poor correlation with actual length, while the APD and TD measurements correlated strongly with the actual measurements. In a study of 61 autopsy prostates, Yip et al (1991) found that while all 3 ultrasonic measurements correlated strongly with caliper measurements, length had the weakest correlation with the actual measurement and with prostate volume. In the present study, L had a stronger correlation with volume than the TD.…”

Section: Discussionmentioning

confidence: 95%

“…The accuracy and simplicity of the diameter method of volume estimation make it practical in the busy clinical situation. Studies on the diameter method are flawed by vague methodology regarding length measurement (Littrup et al, 1991a and b;Yip et al, 1991), which can be difficult because the apex of the prostate is frequently obscured by the echopenic shadow of the external sphincter. In a study by Terris and Stamey (1991), length was measured from the apex to the junction of the central zone and seminal vesicle, which is an easily identifiable landmark.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonically Determined Patterns of Enlargement in Benign Prostatic Hyperplasia

Collins

Lee

Russell

et al. 1993

British Journal of Urology

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A series of 430 men aged 40 to 79 years underwent transrectal ultrasonography (TRUS) as part of a community survey of benign prostatic hyperplasia (BPH). We describe a reproducible method of prostate volume estimation and discuss the implications of prostate dimension changes in BPH. The mean prostate and adenoma volumes for the group were 32 ml (SD 14) and 15 ml (SD 11) respectively. The antero-posterior dimension of the prostate (APD) had the strongest correlation with gland volume compared with the transverse dimension (TD) and length (L). The mean ratio of adenoma volume to prostate volume was 0.45 (SD 0.13) and this increased with increasing gland volume. There was a modest correlation between the ratio and prostate volume. BPH is characterised by a proportionally greater increase in the APD compared with L and TD and by an increasing adenoma/prostate ratio. TRUS is useful in assessing the type and extent of adenoma and prostate enlargement in BPH.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Ultrasonically Determined Patterns of Enlargement in Benign Prostatic Hyperplasia

Collins

Lee

Russell

et al. 1993

British Journal of Urology

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“…The single most common cause for variation of total prostatic volume between examiners is likely selection of precise lower and upper landmarks in the mid-sagittal plane while measuring length [5,28]. Common errors include incorrect identification of the inferior boundary of the apex as the caudal landmark, inconsistent identification of the cranial landmark, making measurements in a parasagittal (rather than mid-sagittal) plane, and measuring from the anterior or posterior prostatic base to apex.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Prostate Volume with MRI (A Guide for the Perplexed): Biproximate Method with Analysis of Precision and Accuracy

Wasserman

Niendorf

Spilseth

2019

Preprint

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Purpose: To review the anatomic basis of prostate boundary selection on T2weighted magnetic resonance imaging (MRI). To introduce an alternative 3D ellipsoid measuring technique that maximizes precision, report the intra-and inter-observer reliability, and to advocate it's use for research involving multiple observers.Methods: A demonstration of prostate boundary anatomy using gross pathology and MRI examples provides background for selection of key boundary marks when measuring prostate volume. An alternative ellipsoid volume method is illustrated. An IRB approved retrospective study of 140 patients with elevated serum prostate specific antigen levels and/or abnormal digital rectal examinations was done with T2weighted MRI applying the new (Biproximate) technique. Measurements were made by 2 examiners, correlated with each other for interobserver precision and with an expert observer for accuracy. Correlation statistics, linear regression analysis, and tests of means were applied using p≤0.05 as the threshold for significance.Results: Inter-observer correlation (precision) was 0.95 between observers.Correlation between these observers and the expert (accuracy) was 0.94 and 0.97 respectively. Intra-observer correlation for the expert was 0.98. Means for inter-rater reliability and accuracy were all the same (p=0.001).Conclusions: Anatomic foundations for the boundaries of the prostate are reviewed.Precision and accuracy of total prostate volume using an alternative method is reported and found to be reproducible.TRUS overestimates post-operative small specimen size and underestimates large prostates [15,16]. However other investigators using MRI EVF volumetrics report overestimation compared to specimen volume (corrected for density of 1.05 gm/cc) [9].There are scant studies of inter-observer reliability for the measurement of total prostatic volume using standard methods [10,11,17]. TRUS intra-rater reliability using the ellipsoid formula was examined in one study and was 0.93 [12]. Bangma, et al. [18] compared TRUS step-section planigraphy with several geometric multiplane models and found the prolate ellipsoid to be comparable (r=0.89). Early application of MRI using the EVF showed acceptable precision and accuracy in one small study [6].The purpose of this study is three-fold. We review detailed anatomy required to more confidently find measurement boundaries. We introduce a new multiplane EVF approach to make these measurements using MRI, and report results of inter-rater and intrarater reliability with this technique. Materials and Methods Patient Selection"This study was approved by our institutional Internal Review Board and Ethics Committee (protocol number 00003941) with a waiver of informed consent". 140 patients were selected from a population of men undergoing MRI because of abnormal PSA, digital rectal examination or both. Ages ranged from 41-76 (mean, 64 years). They were selected by the senior radiologist (NFW) with over 40 years of experience who acted as administrator/expert. All MRI lobar cl...

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“…Collins et al [10] found that for experienced operators the variability could be largely explained by definitions of the length measurement, whilst others have found equal variability in definitions of all dimensions [8]. Others comparing TRUS with actual specimens found similar discrepancies attributable to measurement and interpretation [11,12]. Issues relating to equipment specifications (hardware and software), acquisition technique, interpretation and recording are also likely to contribute to variability.…”

Section: Introductionmentioning

confidence: 99%

The impact of targeted training, a dedicated protocol and on‐site training material in reducing observer variability of prostate and transition zone dimensions measured by transrectal ultrasonography, in multicentre multinational clinical trials of men with symptomatic benign prostatic enlargement

et al. 2007

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methods, which was supplemented at the outset by a compact disc-based video. RESULTSThe mean ( SD ) changes from baseline in TPV at 13 and 26 weeks were − 2.9 (8.9) and − 1.9 (8.5) mL, respectively; the respective mean changes from baseline in TZV were − 1.2 (6.4) and + 0.7 (7.8) mL. For TPV, 80% of the measurements had differences of + 5.2 to − 13.4 mL at 13 weeks, and + 8.0 to − 10.9 mL at 26 weeks. For TZV, 80% of the differences were + 5.8 to − 7.4 at 13 weeks, and + 9.3 to − 6.5 mL at 26 weeks. CONCLUSIONThe performance of TRUS compared favourably with similar published multicentre studies, which we suggest relates in part to the careful implementation of the protocol. We showed that diligent implementation of a detailed protocol, supplemented by targeted training of investigators and provision of onsite training material, promoted consistent acquisition and successful derivation of key clinical trial endpoints. Quantifying the variability of such endpoints will enable us to track deployment quality for future clinical trials, and will ensure that trials are sufficiently powered to define small changes in prostate size.

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Quantitative Analysis of the Accuracy of Linear Array Transrectal Ultrasound in Measurement of the Prostate

Cited by 11 publications

References 6 publications

Ultrasonically Determined Patterns of Enlargement in Benign Prostatic Hyperplasia

Ultrasonically Determined Patterns of Enlargement in Benign Prostatic Hyperplasia

Measurement of Prostate Volume with MRI (A Guide for the Perplexed): Biproximate Method with Analysis of Precision and Accuracy

The impact of targeted training, a dedicated protocol and on‐site training material in reducing observer variability of prostate and transition zone dimensions measured by transrectal ultrasonography, in multicentre multinational clinical trials of men with symptomatic benign prostatic enlargement

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