Ghizlane Moussaoui1, Ahmed Sayed Zakaria2, Cristina Negrean3, David-Dan Nguyen4, Félix Couture5,6, Côme Tholomier7,8, Iman Sadri9, Adel Arezki10, Russell N Schwartz11, Dean Elterman12, Vincent Misrai13, Naeem Bhojani14, Thomas Rw Herrmann15, Kevin Christopher Zorn16,17. 1. McGill University Faculty of Medicine, 12367, Montreal, Quebec, Canada; ghizlane.moussaoui@mail.mcgill.ca. 2. Centre Hospitalier de L'Universite de Montreal, 25443, Urology, Montreal, Quebec, Canada; aszakaria81@yahoo.com. 3. Centre Hospitalier de L'Universite de Montreal, 25443, Department of Surgery, Section of Urology, Montréal, Quebec, Canada; ck.negrean@gmail.com. 4. McGill University Faculty of Medicine, 12367, Montreal, Quebec, Canada; david-dan.nguyen@mail.mcgill.ca. 5. Centre Hospitalier Universitaire de Sherbrooke, 38750, Department of Surgery, Division of Urology, Sherbrooke, Quebec, Canada. 6. Centre Hospitalier de L'Universite de Montreal, 25443, Department of Surgery, Section of Urology, Montréal, Quebec, Canada; felix.couture@mail.mcgill.ca. 7. McGill University Health Centre, 54473, Division of Urology, 1001 Boulevard Décarie, Montréal, Quebec, Canada, H4A 3J1. 8. Centre Hospitalier de L'Universite de Montreal, 25443, Department of Surgery, Section of Urology, 1051 Rue Sanguinet, Montréal, Quebec, Canada, H2X 3E4; come.tholomier@mail.mcgill.ca. 9. McGill University Faculty of Medicine, 12367, Montreal, Quebec, Canada; iman.sadri@mail.mcgill.ca. 10. McGill University Faculty of Medicine, 12367, Montreal, Quebec, Canada; adel.arezki@mail.mcgill.ca. 11. Universite de Montreal Faculte de Medecine, 12368, Montreal, Quebec, Canada; russell.schwartz@umontreal.ca. 12. Memorial Sloan-Kettering Cancer Center, Urology, 1275 York Ave, new york, New York, United States, 10021; deanelterman@gmail.com. 13. Clinique Pasteur, 54918, Service d'Urologie, Toulouse, Midi-Pyrénées, France; vmisrai@clinique-pasteur.com. 14. Centre Hospitalier de L'Universite de Montreal, 25443, Urology, 900 St. Denis street, Pavillon R, R08.474, Montreal, Quebec, Canada, H2X 0A9; naeem.bhojani@gmail.com. 15. Hanover Medical School , Urology, Hanover, Germany; herrmann.thomas@mh-hannover.de. 16. University of Montreal Health Center, Section of Urology, 189 Sanguinet, Montreal, Quebec, Canada, H2X3B5. 17. Universite de Montreal, 5622, Montreal, Canada, H3C 3J7; zorn.chumurology@gmail.com.
Abstract
Background: Prostate size estimation is a valuable clinical measure widely utilized in urology. This study evaluated the accuracy of preoperative transabdominal ultrasound (TAUS) compared to radical prostatectomy specimens and transrectal ultrasound (TRUS) in estimating prostate volume and identifying presence of median lobe, across different size groups, using the standard ellipsoid formula. The effect of median lobe on accuracy was also assessed. Materials and methods: Ninety-eight men undergoing robot-assisted radical prostatectomy were enrolled in this study. Preoperative evaluation of prostate volume was done using measurements obtained from TAUS using the Clarius C3 handheld wireless POCUS and from TRUS Clarius EC7. Participants were grouped based on prostate size (<30g, 30-60g and >60g). Mean absolute percentage of error (MAPE) was used to evaluate accuracy. Mean percentage error determined if there was an overestimation or underestimation. Correlation between each TAUS size group, true prostate weight and TRUS was assessed. Results: Irrespective of BMI, TAUS accurately identified median lobe in all men. No statistically significant difference was found between specimen weight and TAUS prostate size for the >60g group. Amongst this same group, a strong correlation was noted between specimen weight and TAUS prostate size (r=0.911, p<0.001). There was also a strong correlation between TAUS and TRUS measurements for this group (r=0.950, p<0.001). Presence of median lobe did not have an impact on measurement accuracy. Conclusions: Bedside handheld wireless POCUS provides rapid, inexpensive, non-invasive and clinically accurate TAUS prostate assessments for larger prostates. Such features as identifying median lobes and measuring prostate volumes are valuable tools while patient counselling on lower urinary tract symptoms (LUTS), elevated prostate specific antigen (PSA) and benign prostate hyperplasia (BPH) surgical options.
Background: Prostate size estimation is a valuable clinical measure widely utilized in urology. This study evaluated the accuracy of preoperative transabdominal ultrasound (TAUS) compared to radical prostatectomy specimens and transrectal ultrasound (TRUS) in estimating prostate volume and identifying presence of median lobe, across different size groups, using the standard ellipsoid formula. The effect of median lobe on accuracy was also assessed. Materials and methods: Ninety-eight men undergoing robot-assisted radical prostatectomy were enrolled in this study. Preoperative evaluation of prostate volume was done using measurements obtained from TAUS using the Clarius C3 handheld wireless POCUS and from TRUS Clarius EC7. Participants were grouped based on prostate size (<30g, 30-60g and >60g). Mean absolute percentage of error (MAPE) was used to evaluate accuracy. Mean percentage error determined if there was an overestimation or underestimation. Correlation between each TAUS size group, true prostate weight and TRUS was assessed. Results: Irrespective of BMI, TAUS accurately identified median lobe in all men. No statistically significant difference was found between specimen weight and TAUS prostate size for the >60g group. Amongst this same group, a strong correlation was noted between specimen weight and TAUS prostate size (r=0.911, p<0.001). There was also a strong correlation between TAUS and TRUS measurements for this group (r=0.950, p<0.001). Presence of median lobe did not have an impact on measurement accuracy. Conclusions: Bedside handheld wireless POCUS provides rapid, inexpensive, non-invasive and clinically accurate TAUS prostate assessments for larger prostates. Such features as identifying median lobes and measuring prostate volumes are valuable tools while patient counselling on lower urinary tract symptoms (LUTS), elevated prostate specific antigen (PSA) and benign prostate hyperplasia (BPH) surgical options.