Anatomical Science International

, Volume 86, Issue 2, pp 78–85 | Cite as

Assessment of in vivo calculation with ultrasonography compared to physical sections in vitro: a stereological study of prostate volumes

  • Niyazi Acer
  • Mustafa Sofikerim
  • Tolga Ertekin
  • Erdoğan Unur
  • Mahmut Çay
  • Figen Öztürk
Original Article

Abstract

We compared three methods for the determination of prostate volume: prostate volume measured via transrectal ultrasonography (TRUS); the Cavalieri method for measuring physical sections; and volume by displacement. TRUS volumes were calculated by the prolate ellipsoid volume formula. Five patients underwent TRUS examination of the prostate prior to radical prostatectomy; specimens were measured when freshly excised. Mean prostate volume by fluid displacement, before formalin fixation was 52.8 ± 21.5 cm3, and after formalin fixation 50.4 ± 20.9 cm3. Volumes determined by the Cavalieri principle (point-counting and planimetry) were 47.8 ± 19.3 and 49.1 ± 20.5 cm3; volume measured by TRUS was 42.9 ± 21.9 cm3. Thus TRUS underestimated prostate volume by 21.4%, but excellent agreement was found between actual volume and point counting techniques. We believe that the classic ellipsoid formula is inadequate for determining prostate volume.

Keywords

Prostate volume Real volume Transrectal ultrasound Physical sectioning Stereology 

Notes

Acknowledgments

We wish to thank Dr. Marta García-Fiñana, Prof. Kenan Aycan, and Prof. Harun Ulger for skilful technical assistance. We thank Dr. Ahmet Öztürk for statistical analysis. Author contributions: the authors of this paper contributed to this research as follows: initial conception and design (N.A., M.S., T.U., E.U., M.C., F.Ö.); administrative, technical, or material support (N.A., E.U., T.U.); acquisition of data (N.A., M.S., T.U., E.U.); laboratory analysis and interpretation of data (N.A., M.S., M.C., F.Ö.); drafting of the manuscript (N.A., T.E., E.U.); critical revision of the manuscript for important intellectual content (N.A., M.S., T.U., E.U., M.C.). The views expressed herein are those of the authors and not necessarily their institutions or sources of support.

References

  1. Aarnink RG, Giesen RJ, de la Rosette JJ, Huynen AL, Debruyne FM, Wijkstra H (1995) Planimetric volumetry of the prostate: how accurate is it? Physiol Meas 16:141–150PubMedCrossRefGoogle Scholar
  2. Aarnink RG, De La Rosette JJ, Debruyne FM, Wijkstra H (1996) Reproducibility of prostate volume measurements from transrectal ultrasonography by an automated and a manual technique. Br J Urol 78:219–223PubMedGoogle Scholar
  3. Algan O, Hanks GE, Shaer AH (1995) Localization of the prostatic apex for radiation treatment planning. Int J Radiat Oncol Biol Phys 33:925–930PubMedCrossRefGoogle Scholar
  4. Al-Qaisieh B, Ash D, Bottomley DM, Carey BM (2002) Impact of prostate volume evaluation by different observers on CT-based post-implant dosimetry. Radiother Oncol 62:267–273PubMedCrossRefGoogle Scholar
  5. Bapat S, Purnapatre S, Ketan P, Pushkaraj Y, Abhijit P, Bodhe Y (2006) Does estimation of prostate volume by abdominal ultrasonography vary with bladder volume: a prospective study with transrectal ultrasonography as a reference. Indian J Urol 22:322–325CrossRefGoogle Scholar
  6. Bates TS, Reynard JM, Peters TJ, Gingell JC (1996) Determination of prostatic volume with transrectal ultrasound: a study of intra-observer and interobserver variation. J Urol 155:1299–1300PubMedCrossRefGoogle Scholar
  7. Berthelet E, Liu MC, Agranovich A et al (2002) Computed tomography determination of prostate volume and maximum dimensions: a study of interobserver variability. Radiother Oncol 63:37–40PubMedCrossRefGoogle Scholar
  8. Cruz-Orive LM (1993) Systematic sampling in stereology. Bull Int Stat Inst 55:451–468Google Scholar
  9. Elliot TL, Downey DB, Tong S, McLean CA, Fenster A (1996) Accuracy of prostate volume measurements in vitro using three-dimensional ultrasound. Acad Radiol 3:401–406PubMedCrossRefGoogle Scholar
  10. Eri LM, Thomassen H, Brennhovd B, Håheim LL (2002) Accuracy and repeatability of prostate volume measurements by transrectal ultrasound. Prostate Cancer Prostatic Dis 5:273–278PubMedCrossRefGoogle Scholar
  11. García-Fiñana M, Cruz-Orive LM, Mackay CE, Pakkenberg B, Roberts N (2003) Comparison of MR imaging against physical sectioning to estimate the volume of human cerebral compartments. Neuroimage 18:505–516PubMedCrossRefGoogle Scholar
  12. Gundersen HJG (1988) Some new simple and efficient stereological methods and their use in pathological research and diagnosis. Acta Pathol Microbiol Immunol Scand A 96:379–394Google Scholar
  13. Gundersen HJG, Jensen EB (1987) The efficiency of systematic sampling in stereology and its prediction. J Microsc 147:229–263PubMedGoogle Scholar
  14. Gundersen HJ, Jensen EB, Kiêu K, Nielsen J (1999) The efficiency of systematic sampling in stereology reconsidered. J Microsc 193:199–211PubMedCrossRefGoogle Scholar
  15. Howard CV, Reed MG (1998) Unbiased stereology. Three-dimensional measurement in microscopy. Bios, Oxford, pp 39–54Google Scholar
  16. Hu N, Downey DB, Fenster A, Ladak HM (2003) Prostate boundary segmentation from 3D ultrasound images. Med Phys 30:1648–1659PubMedCrossRefGoogle Scholar
  17. Jeong CW, Park HK, Hong SK, Byun SS, Lee HJ, Lee SE (2008) Comparison of prostate volume measured by transrectal ultrasonography and MRI with the actual prostate volume measured after radical prostatectomy. Urol Int 81(2):179–185PubMedCrossRefGoogle Scholar
  18. Jonmarker S, Valdman A, Lindberg A, Hellström M, Egevad L (2006) Tissue shrinkage after fixation with formalin injection of prostatectomy specimens. Virchows Arch 449:297–301PubMedCrossRefGoogle Scholar
  19. Jørgen H, Gundersen G, Boysen M, Reith A (1981) Comparison of semiautomatic digitizer-tablet and simple point counting performance in morphometry. Virchows Arch B Cell Pathol Incl Mol Pathol 37:317–325PubMedCrossRefGoogle Scholar
  20. Kimura A, Kurooka Y, Kitamura T, Kawabe K (1997) Biplane planimetry as a new method for prostatic volume calculation in transrectal ultrasonography. Int J Urol 4:152–156PubMedCrossRefGoogle Scholar
  21. Lee JS, Chung BH (2007) Transrectal ultrasound versus magnetic resonance imaging in the estimation of prostate volume as compared with radical prostatectomy specimens. Urol Int 78:323–327PubMedCrossRefGoogle Scholar
  22. Littrup PJ, Williams CR, Egglin TK, Kane RA (1991) Determination of prostate volume with transrectal US for cancer screening. II. Accuracy of in vitro and in vivo techniques. Radiology 179:49–53PubMedGoogle Scholar
  23. Mathieu O, Cruz-Orive LM, Hoppeler H, Weibel ER (1981) Measuring error and sampling variation in stereology: comparison of the efficiency of various methods for planar image analysis. J Microsc 121:75–88PubMedGoogle Scholar
  24. Matthews GJ, Motta J, Fracehia JA (1996) The accuracy of transrectal ultrasound prostate volume estimation: clinical correlations. J Clin Ultrasound 24:501–505PubMedCrossRefGoogle Scholar
  25. Mazonakis M, Karampekios S, Damilakis J, Voloudaki A, Gourtsoyiannis N (2004) Stereological estimation of total intracranial volume on CT images. Eur Radiol 14:1285–1290PubMedCrossRefGoogle Scholar
  26. Myschetzky PS, Suburu RE, Kelly BS Jr, Wilson ML, Chen SC, Lee F (1991) Determination of prostate gland volume by transrectal ultrasound: correlation with radical prostatectomy specimens. Scand J Urol Nephrol 137:107–111Google Scholar
  27. Noguchi M, Stamey TA, McNeal JE, Yemoto CE (2000) Assessment of morphometric measurements of prostate carcinoma volume. Cancer 89:1056–1064PubMedCrossRefGoogle Scholar
  28. Pache JC, Roberts N, Vock P, Zimmermann A, Cruz-Orive LM (1993) Vertical LM sectioning and parallel CT scanning designs for stereology: application to human lung. J Microsc 170:9–24PubMedGoogle Scholar
  29. Roehrborn CG (1998) Accurate determination of prostate size via digital rectal examination and transrectal ultrasound. Urology 51:19–22Google Scholar
  30. Sahin B, Ergur H (2006) Assessment of the optimum section thickness for the estimation of liver volume using magnetic resonance images: a stereological gold standard study. Eur J Radiol J 57:96–101CrossRefGoogle Scholar
  31. Sahin B, Emirzeoglu M, Uzun A, Incesu L, Bek Y, Bilgic S, Kaplan S (2003) Unbiased estimation of the liver volume by the Cavalieri principle using magnetic resonance images. Eur J Radiol 47:164–170PubMedCrossRefGoogle Scholar
  32. Schned AR, Wheeler KJ, Hodorowski K, Heaney JA, Ernstoff MS, Amdur RJ, Harris RD (1996) Tissue-shrinkage correction factor in the calculation of prostate cancer volume. Am J Surg Pathol 20:1501–1506PubMedCrossRefGoogle Scholar
  33. Sosna J, Rofsky NM, Gaston SM, DeWolf WC, Lenkinski RE (2003) Determinations of prostate volume at 3-Tesla using an external phased array coil: comparison to pathologic specimens. Acad Radiol 10:846–853PubMedCrossRefGoogle Scholar
  34. Terris MK, Stamey TA (1991) Determination of prostate volume by transrectal ultrasound. J Urol 145:985–987Google Scholar
  35. Tewari A, Indudhara R, Shinohara K, Schalow E, Woods M, Lee R, Anderson C, Narayan P (1996) Comparison of transrectal ultrasound prostatic volume estimation with magnetic resonance imaging volume estimation and surgical specimen weight in patients with benign prostatic hyperplasia. J Clin Ultrasound 24:169–174PubMedCrossRefGoogle Scholar
  36. Watanabe H, Kaiho H, Tanaka M, Terasawa Y (1971) Diagnostic application of ultrasonotomography to the prostate. Invest Urol 8:548–559PubMedGoogle Scholar

Copyright information

© Japanese Association of Anatomists 2010

Authors and Affiliations

  • Niyazi Acer
    • 1
  • Mustafa Sofikerim
    • 2
  • Tolga Ertekin
    • 1
  • Erdoğan Unur
    • 1
  • Mahmut Çay
    • 1
  • Figen Öztürk
    • 3
  1. 1.Department of AnatomyErciyes University School of MedicineKayseriTurkey
  2. 2.Department of UrologyErciyes University School of MedicineKayseriTurkey
  3. 3.Department of PathologyErciyes University School of MedicineKayseriTurkey

Personalised recommendations