OBJECTIVE: The objective of this study was to investigate impact of prostate volume variations on prostate-specific antigen density (PSAD) and patient eligibility for active surveillance (AS).
METHODS: Prostate volume and PSAD were calculated for 46 patients with prostate cancer in AS who underwent prostate magnetic resonance imaging and transrectal ultrasound (TRUS). Manual method and 2 semiautomated methods for prostate segmentation (3D-SLICER and OsiriX) were used for MR volumetry.
RESULTS: Magnetic resonance volumetric methods showed very good agreement (intraclass correlation coefficient, 0.98). The concordance correlation coefficient was higher among MR volumetry methods (0.971-0.998) than between TRUS and MR volumetry (0.849-0.863). The variation in PSAD estimated by TRUS versus magnetic resonance imaging was higher in large prostates (r = 0.327, P = 0.027). Transrectal ultrasonography volumetry may improperly classify 20% of patients as eligible for AS with PSAD greater than 0.15 threshold.
ONCLUSIONS: CAlthough clinically used TRUS reliably estimates PSAD, it may misclassify some patients who are not eligible for AS based on PSAD criteria. Magnetic resonance-based volumetry should be considered for a more reliable PSAD calculation.
Written by:
Dianat SS, Rancier Ruiz RM, Bonekamp D, Carter HB, Macura KJ. Are you the author?
The Russell H. Morgan Department of Radiology Radiological Science, The Johns Hopkins University, Baltimore, MD; Department of Internal Medicine, Jacobi Medical Center, New York, NY; and ‡The James Buchanan Brady Urological Institute, The Johns Hopkins University, Baltimore, MD.
Reference: J Comput Assist Tomogr. 2013 Jul-Aug;37(4):589-95.
doi: 10.1097/RCT.0b013e318296af5f
PubMed Abstract
PMID: 23863537
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