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Prostate Volume in Patients Undergoing Primary Surgical or Radiotherapeutic Management of Localized Adenocarcinoma: Implications for Design of Minimally Invasive Imaging and Treatment Devices for the Prostate

Davis BJ, Leenstra JL, Wilson TM, Mynderse LA, Solhjem MC, Herman MG, Hillman DW, Allen-Ziegler KL, Cheville JC, King BF and Holmes III DR

Introduction: The objective of this study was to collect and analyze prostate volumetric data from different patient cohorts treated for localized prostate cancer. These data were examined with respect to the design of minimally invasive treatment devices for localized prostate cancer.
Methods: Among 700 patients with prostate cancer (stages T1a-T3c), 342 had radical retropubic prostatectomy (RRP) specimens submitted for whole mounting; 308 received permanent prostate brachytherapy and underwent transrectal ultrasonography (TRUS); and 50 received external beam radiotherapy with computed tomographic (CT)- based 3-dimensional treatment planning. Analysis included cumulative histograms, descriptive statistics, and statistical comparisons of median height, width, length, and volume.
Results: Median prostate dimensions (in millimeters) and volumes (in cubic centimeters) were as follows: Height by RRP was 30; TRUS prolate, 33; TRUS planimetry, 35; and CT, 42. Width by RRP was 47; TRUS prolate, 50; TRUS planimetry, 51; and CT, 51. Length by RRP was 42; TRUS prolate, 49; TRUS planimetry, 45; and CT, 41. Volume by RRP was 32; TRUS prolate, 41; TRUS planimetry, 43; and CT, 45.
Conclusions: Although median TRUS and CT volumes were similar (41-45 cm3), median RRP volume was 9 to 13 cm3 less. Of the cases examined, 75% would be encompassed by an imaging device with an azimuthal field of view of 48 to 55 mm and 95% by a device with a length of 54 to 63 mm.