Variability in MRI vs. ultrasound measures of prostate volume and its impact on treatment recommendations for favorable-risk prostate cancer patients: a case series

Radiation Oncology

Paul L Nguyen¹  Andriy Y Fedorov¹  Robert A Cormack³  Antonio L Damato³  Ivan Buzurovic³  Michael O’Leary¹  Graeme Steele¹  Desmond A O’Farrell³  Emily H Neubauer Sugar³  Clare Mary C Tempany¹  Phillip M Devlin¹  W Warren Suh²  Thomas R Niedermayr¹  Peter F Orio¹  Kemal Tuncali¹  Fiona M Fennessy¹  Arti Parekh³  Luciant D Wolfsberger³  Yonina R Murciano-Goroff¹ 

[1] Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA;Cancer Center of Santa Barbara, 519 W. Junipero Street, Santa Barbara, CA 93105, USA;Dana-Farber Cancer Institute, 50 Brookline Avenue, Boston, MA 02115, USA

关键词: Ultrasound;    MRI;    Active surveillance;    Brachytherapy;    Favorable-risk prostate cancer;    Prostate volume;   

Others  :  1151376
DOI  :  10.1186/1748-717X-9-200

 received in 2014-06-27, accepted in 2014-09-02,  发布年份 2014

【 摘 要 】

Background

Prostate volume can affect whether patients qualify for brachytherapy (desired size ≥20 mL and ≤60 mL) and/or active surveillance (desired PSA density ≤0.15 for very low risk disease). This study examines variability in prostate volume measurements depending on imaging modality used (ultrasound versus MRI) and volume calculation technique (contouring versus ellipsoid) and quantifies the impact of this variability on treatment recommendations for men with favorable-risk prostate cancer.

Methods

We examined 70 patients who presented consecutively for consideration of brachytherapy for favorable-risk prostate cancer who had volume estimates by three methods: contoured axial ultrasound slices, ultrasound ellipsoid (height × width × length × 0.523) calculation, and endorectal coil MRI (erMRI) ellipsoid calculation.

Results

Average gland size by the contoured ultrasound, ellipsoid ultrasound, and erMRI methods were 33.99, 37.16, and 39.62 mLs, respectively. All pairwise comparisons between methods were statistically significant (all p < 0.015). Of the 66 patients who volumetrically qualified for brachytherapy on ellipsoid ultrasound measures, 22 (33.33%) did not qualify on ellipsoid erMRI or contoured ultrasound measures. 38 patients (54.28%) had PSA density ≤0.15 ng/dl as calculated using ellipsoid ultrasound volumes, compared to 34 (48.57%) and 38 patients (54.28%) using contoured ultrasound and ellipsoid erMRI volumes, respectively.

Conclusions

The ultrasound ellipsoid and erMRI ellipsoid methods appeared to overestimate ultrasound contoured volume by an average of 9.34% and 16.57% respectively. 33.33% of those who qualified for brachytherapy based on ellipsoid ultrasound volume would be disqualified based on ultrasound contoured and/or erMRI ellipsoid volume. As treatment recommendations increasingly rely on estimates of prostate size, clinicians must consider method of volume estimation.

【 授权许可】

   
2014 Murciano-Goroff et al.; licensee BioMed Central Ltd.

【 图 表 】

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