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Transition zone volume on transrectal ultrasonography is more accurate and reproducible than the total prostate volume

par Zlolta, Alexandre A.R.;Djavan, Bob ;Roumeguere, Thierry ;Marberger, Michael Johann;Schulman, Claude
Référence British journal of urology, 80, SUPPL. 2, page (236)
Publication Publié, 1997

Article révisé par les pairs

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Résumé :

Transrectal ultrasound (TRUS) is a valuable daily tool for urologists. Prostate volume imaging by TRUS has been shown to be highly variable between different observers and this may lead to important differences in prostate specific antigen density values. We have recently shown that the prostate specific antigen density related to the transition zone (TZ) of the prostate was a new accurate parameter for cancer prediction. The aim of the study was to assess the reliability and accuracy of TZ volume measurement. In 19 patients with benign prostatic hyperplasia (BPH) and 20 patients with prostate cancer, TRUS was performed prior to retropubic adenomectomy or radical prostatectomy. TZ volume and total volume were calculated with the prolate ellipsoid formula. For each distance, minimal and maximal values were recorded, both for TZ and total volume. TZ volume and specimen volume (adenoma) as well as total prostate volume and radical prostatectomy specimen were compared. The weight of the operated BPH specimens was 34.41 ±6.08 g while the calculated TZ volume was 31. L7 ±5.50 ce (p>0.05, NS). The weight of the radical prostatectomy specimens was 30.40 ±8.72 g while calculated volume of the entire gland was 26.90 ± 7.53 cc (p<0.05). When calculating maximum and minimum TZ volume, a difference of -9 to +7% was observed while for total prostate volume this difference reached -11 to +17% (p<0.05). One single difference of 1 cm in the cephalocaudal distance of the total prostate volume leads to more than 20% difference in the volume of the total prostate. TZ volume measurement is easy, reliable and reproducible. Because of the absence of the hypoechoic triangle at the apex of the TZ in the cephalocaudal plane, variability in TZ measurement is decreased. TZ volume measurement can be therefore reliably used to calculate the TZ related PSA density, which seems to be a promissing parameter in cancer prediction or when assessing the volume of an adenoma prior to medical or surgical treatment for BPH.