Prolate Ellipsoid Formula Research Articles

Estimation of standard splenic volume in Saudi Arabian adult population: using 3D reconstruction of abdominal CT scan images

Abstract Purpose: Spleen is enlarged in a variety of clinical conditions including infectious, infiltrative, immunologic and malignant states. Evaluation of splenic size is important in every physical examination of the abdomen by a physician. Determination of its size by palpation can be extremely inaccurate because spleen is never palpable till it is enlarged 2 to 3 times its own size. The accurate diagnosis of splenic enlargement is a matter of considerable importance as it is a useful guide for arriving at a diagnosis of the disease. It is therefore of utmost importance to resort to a mechanism that will give us an accurate estimation of the size of spleen. Aim of this work was to determine the normal range of spleen dimensions in average adult Saudi Arabian population and compare it from the published data. Methods: CT scans of 34 adult patients (male and female) aged between 20-70 years, having no splenic disorders, were collected from department of radio-diagnosis King Khalid Hospital Al-Kharj, KSA. Splenic volume was measured by two methods— by volumetric software and the prolate ellipsoid formula. Results: The average splenic volume of all subjects was 161.42 ±54.91 cm3 with a range of 106-319 cm3. The average splenic volume of males was 196.95 ±48.70 cm3 and that of female was 196.95 ±26.97 cm3. Conclusion: These results provide normative data for evaluating patients with splenic enlargement.

Ultrasonographic assessment of splenic volume and its correlation with body parameters in a Jordanian population.

Objectives:To estimate normal linear dimensions and volume of spleen in Jordanians using ultrasonography, and to correlate splenic volume with age and body parameters: height, weight, body surface area (BSA), and body mass index (BMI).Methods:A prospective pilot study was conducted on 205 volunteers (115 males and 90 females) not known to have any conditions likely to be associated with splenomegaly. The study was performed at the Radiology Department, Jordanian University Hospital, Amman, Jordan, between December 2013 and August 2014. All linear dimensions of spleen were measured, and splenic volume (index) was calculated using the standard prolate ellipsoid formula (length × width × depth × 0.523). The splenic volume was then analyzed with age and body parameters using the Pearson’s correlation coefficient.Results:The mean (± SD) splenic dimensions were 10.72±1.37 cm in length, 7.40±1.52 cm in width, 4.40±1.47 cm in depth, and 184.15±79.56 cm3 in volume. Men had larger spleens than women (p<0.0001). Age had no significant effect on spleen volume (r=0.11, p=0.12). There was a significant moderate positive correlation (p<0.0001), using Pearson’s correlation coefficient, between the spleen volume, and other parameters (height, weight, BSA, and BMI), with correlation coefficients exceeding 0.3.Conclusion:A local reference of spleen dimensions was established with a different range of values reported previously.

Ovarian lesion volumes as a screening tool for malignancy in adolescent ovarian tumors

BackgroundPreoperative evaluation of ovarian tumors for malignancy is essential to determine appropriate treatment. Our study assessed the utility of ovarian lesion volumes to screen for malignancy in adolescent ovarian lesions. MethodsA retrospective chart review of adolescent patients (8–18years) who underwent an ovarian operation from January 2008 to December 2012. Data included demographics, ultrasonographic volume measurements, and tumor markers. Volumes were calculated using the prolate ellipsoid formula. Data are presented as medians. ResultsOne hundred twenty-three females were included at a median age of 13.7years (IQR 12.5–16). Eight patients had malignancies. The median benign lesion volume was significantly smaller than malignant [152cm3 (IQR 57–592)vs. 1548cm3 (IQR 627–2105), p=0.001].A receiver operating characteristic (ROC) curve analysis (AUC 0.84, p=0.001) revealed a threshold ovarian lesion volume of <184cm3 (100% sensitivity, 54% specificity, NPV 100%, PPV 13%) to accurately screen for malignancy. This held true when applied to our dataset as none of the 62 girls with volumes <184cm3 had malignant pathology. ConclusionsThis is the first documented use of ovarian lesion volumes as a screening tool in adolescent ovarian lesions. This should be used in conjunction with tumor markers and other imaging features to better screen for malignancy.

Ultrasonographically Calculated Uterine Mass as a Predictor for Surgical Outcomes in Total Laparoscopic Hysterectomy

Abstract Background: With more laparoscopic hysterectomies being performed for increasingly large uteri, prediction of surgical outcomes is becoming more important. There is a paucity of information regarding preoperative predictors of surgical outcomes in the large uterus that could be helpful in perioperative planning. Objective: The aim of this research was to examine the predictive value of ultrasonographically-measured uterine mass on surgical outcomes in total laparoscopic hysterectomy (TLH). Materials and Methods: This was a retrospective exploratory study analyzing surgical outcomes following TLH over a 15-year period. Subjects were recruited in four San Francisco area hospitals. For 1004 patients, data were collected regarding demographics, ultrasonographically measured uterine volumes, and surgical outcomes (operative time, estimated blood loss [EBL], length of hospital stay, and postoperative uterine mass). Uterine mass was calculated using the prolate ellipsoid formula and a volume-to-mass con...

A postmortem study on the volume of the human kidney

Context: Kidney volume is a sensitive index of kidney size for the detection of renal abnormalities. It is also excellent predictor of renal function and correlates very well with body indexes. The present study was done on cadaveric specimens to see the age related changes in the volume of the kidney in a Bangladeshi population and to compare with the previous local and foreign studies. Methods: This cross-sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2008 to June 2009, based on collection of 140 post mortem human kidneys from 70 unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. All the samples were divided into three age groups including A (10-19 years), B (20-39 years) and C (40-59 years). The length, breadth and thickness of each kidney were measured by using a slide calipers and recorded. Then the volume was determined by using prolate ellipsoid formula i.e. length × breadth × thickness × 0.52. Results: The volume of the right and left kidneys were found 54.46±4.02 cm3 and 53.15±1.98 cm3 in group A, 78.31±10.41 cm3 and 75.90±8.32 cm3 in group B, 74.47±6.22 cm3 and 73.34±6.80 cm3 in group C. No statistically significant difference was found between the right and the left kidney in any group. However, statistically significant differences were evident between A &amp; B and A &amp; C (P&lt;0.001). Conclusion: No difference was found in volume between the right and the left kidney in any group. However, kidney volume was found to increase with advancing age in apparently healthy Bangladeshi people. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22698 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 73-77

Evaluation of kidney status by ultrasonography in canines: an experimental study

Kidney is a major organ for homeostasis of the body's extracellular fluids by maintaining a constant internal environment. By playing such crucial responsibility kidney remains vulnerable for various diseases and disease condition. Other than laboratory findings, application of ultrasonography can be considered as one of the finest diagnostic tool to determine the architectural detail of kidney. To compare the study, we have taken two groups of canine, namely healthy and clinical. The later grouped was screened based on clinical signs, Blood Urea Nitrogen (BUN) and Serum Creatinine value. Sonography was performed by using Brightness mode instrument for both the groups. The values were analyzed by Prolate Ellipsoid formula to estimate the volume of kidney. There was significant variation in sizes between the kidneys of both the groups. Moreover, the size of the kidneys of few clinical cases, which has been suffering from renal disorder since long, reveals smaller size kidney than the healthy groups. Thus, this noninvasive method is quite practicable to evaluate the size of kidney amongst various renal failure cases. DOI: http://dx.doi.org/10.3329/ralf.v1i1.22373 Res. Agric., Livest. Fish.1(1): 105-108, Dec 2014

Comparison of Prostate Volume Measured by Endorectal Coil MRI to Prostate Specimen Volume and Mass After Radical Prostatectomy

To compare prostate volume measurements from 3-Tesla endorectal coil magnetic resonance imaging (ERC MRI) obtained with the prolate ellipsoid volume formula (EVF) and volumetry to pathology-based volume measurements. The institutional review board waived informed consent for this retrospective, health insurance portability and accountability act (HIPAA) compliant study, which included 195 patients who underwent 3-T ERC MRI between January 2008 and October 2011 and had pathologic prostate measurements available. Two readers in consensus measured the prostate length, height, and width on each MRI. They estimated prostate volumes using the prolate EVF (length × height × width × [π/6]) and also by performing three-dimensional volumetry. Pathologic specimen mass and dimensions were used to calculate prostate volume. Agreement was measured with Lin's concordance correlation coefficient (CCC). Volume differences were assessed using the Wilcoxon signed-rank test. Correct prostate-specific antigen (PSA) density classification rates were compared between EVF-based and volumetry-based PSA density levels using the exact McNemar test, with pathology-based PSA density as the reference standard. Concordance was high between EVF and volumetry measurements (CCC, 0.950 [95% confidence interval, 0.935-0.962]) and between both kinds of MRI measurements and pathology (both CCC > 0.80). Based on a cut-off of ≤0.15 ng/mL/cm(3), use of EVF-based volume produced correct classification of 46 of 48 PSA density levels >15 ng/mL/cm(3) and 113 of 147 PSA density levels ≤15 ng/mL/cm(3); use of volumetry-based volume produced correct classification of 47 of 48 PSA density levels >15 ng/mL/cm(3) and 121 of 147 PSA density levels ≤15 ng/mL/cm(3). Rates of underclassification (P > .95) and overclassification (P = .10) did not differ significantly between EVF and volumetry. EVF appears to be suitable for measuring prostate volume from ERC-MRI.

Cadaver study of the volume of the ovary in Bangladeshi women.

Reproductive age, ovarian reserve and reproductive capability may be determined from the volume of the ovary. A cross-sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2009, to see the variation in the volume of the ovary with age in Bangladeshi women. The study was performed on 140 post mortem human ovaries collected from 70 unclaimed female dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age-groups including group A (10-13 years), group B (1445 years) & group C (46-52 years). Group A is pre-menarche group, group B represents reproductive age and group C is post menopausal group. The length, breadth and thickness of each ovary were measured by using a slide calipers. Then the volume of each ovary was determined by the product of its length, breadth and thickness multiplied by 0.524, according to the Prolate ellipsoid formula. The mean volume of the right ovary was found higher than that of the left one in all age groups (p < 0.001). The difference in mean volume of the ovary between group A & group B, group B & group C (p < 0.001) and group A & group C (p < 0.01) were also statistically significant. The volume of the ovary increases with age and then gradually starts to decrease from menopause.

Accuracy of Transrectal Ultrasonography to Evaluate Pathologic Prostate Weight: Correlation With Various Prostate Size Groups

To report the accuracy of transrectal ultrasonography (TRUS) to measure prostate size before robotic-assisted radical prostatectomy using the prolate ellipsoid formula and its correlation to the weight of the postoperative prostate specimen, for different prostate size groups. Preoperative prostate size estimated by TRUS and the weight of postoperative prostate specimens were collected from 440 men undergoing robotic-assisted radical prostatectomy. Patients were grouped according to preoperative prostate size:<30, 30-60, 60-80, and≥80 g. To evaluate accuracy, the mean absolute percentage of error was used. The mean percentage of error was used to indicate whether the estimation of TRUS had a tendency to overestimate or underestimate prostate size. The correlation between both measurements was analyzed for each size group. Accuracy of TRUS estimation was associated with increased prostate size. TRUS estimation was more accurate for larger prostates. The mean absolute percentage of error of each group was 38.64% (<30 g), 21.33% (30-60 g), 13.23% (60-80 g), and 14.96% (≥80 g). Correlation followed a similar size-dependent trend, with a stronger r coefficient for larger prostates: 0.174 (<30 g), 0.327(30-60 g), 0.457 (60-80 g), and 0.839 (≥80 g). Interestingly, smaller prostates were underestimated, whereas larger glands (≥80 g) had a tendency to be overestimated by TRUS. This study demonstrates that the accuracy of the prolate ellipsoid formula for TRUS varies according to prostate size. Although this formula is fairly accurate for assessing larger prostates, it shows some limitations for smaller prostates. This must be taken into account when evaluating treatment modalities such as transurethral incision of the prostate and brachytherapy.

The association of tumor volume with mortality following radical prostatectomy

Data regarding the prognostic significance of tumor volume (TV) in prostate cancer are conflicting. Herein, we evaluated the association of TV with prostate cancer mortality following radical prostatectomy (RP), and assessed the additive prognostic value of TV to an established predictive model. We identified 13,687 patients who underwent RP without preoperative therapy between 1987 and 2009. TV was estimated using the prolate ellipsoid formula. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of TV with mortality. The ability of TV to enhance the performance of an established prognostic model (Mayo Clinic GPSM (Gleason, PSA, seminal vesicle and margin status) score) was assessed using the c-index. Median TV was 1.57 cm(3) (interquartile range (IQR) 0.48-4.19). Increasing TV was associated with significantly higher risks of seminal vesicle invasion (hazard ratio (HR) 1.58; P<0.0001), positive surgical margins (HR 1.28; P<0.0001) and lymph node involvement (HR 1.26; P<0.0001). Median postoperative follow-up was 9.4 years (IQR 5.0-14.5). Patient grouping into quartiles according to TV resulted in a significant stratification of outcome, as the 15-year cancer-specific survival by TV quartile was 99%, 98%, 95% and 88%, respectively (P<0.0001). Moreover, on multivariate analysis, greater TV remained associated with significantly increased risks of systemic progression (HR 1.27; P<0.0001), death from prostate cancer (HR 1.29; P<0.0001) and all-cause mortality (HR 1.05; P<0.0001). Meanwhile, addition of TV to the GPSM score increased the c-index for the model's prediction of prostate cancer mortality from 0.803 to 0.822. TV is associated with survival following RP, and enhances, although modestly, the performance of an established prediction model. As such, TV warrants continued assessment in risk stratification tools.

Estimation of Standard Splenic Volume in Saudi Arabian Adult Population: Using 3D Reconstruction of Abdominal CT Scan Images

Purpose: Spleen is enlarged in a variety of clinical conditions including infectious, infiltrative, immunologic and malignant states. Evaluation of splenic size is important in every physical examination of the abdomen by a physician. Determination of its size by palpation can be extremely inaccurate because spleen is never palpable till it is enlarged 2 to 3 times its own size. The accurate diagnosis of splenic enlargement is a matter of considerable importance as it is a useful guide for arriving at a diagnosis of the disease. It is therefore of utmost importance to resort to a mechanism that will give us an accurate estimation of the size of spleen. Aim of this work was to determine the normal range of spleen dimensions in average adult Saudi Arabian population and compare it with the published data. Methods: CT scans of 34 adult patients (male and female) aged between 20 - 70 years, having no splenic disorders, were collected from department of radio-diagnosis King Khalid Hospital Al-Kharj, KSA. Splenic volume was measured by two methods—by volumetric software and the prolate ellipsoid formula. Results: The average splenic volume of all subjects was 161.42 ± 54.91 cm3 with a range of 106 - 319 cm3. The average splenic volume of males was 196.95 ± 48.70 cm3 and that of female was 196.95 ± 26.97 cm3. Conclusions: These results provide normative data for evaluating patients with splenic enlargement.

Twin Reversed Arterial Perfusion Sequence

The purpose of this study was to test the hypothesis that using the formula of a prolate ellipsoid to estimate parabiotic twin mass correlates better with findings of pump twin compromise than using the sonographic method of Moore et al (Am J Obstet Gynecol 1990; 163:907-912). A 10-year retrospective review was performed to identify all cases of the suspected twin reversed arterial perfusion (TRAP) sequence. Parabiotic twin mass was estimated by summing body and extremity volumes calculated using the prolate ellipsoid formula (width × height × length × 0.523). Parabiotic twin mass was also estimated using the sonographic Moore method [1.21 × length(2) - (1.66 × length)]. Parabiotic twin mass estimated by both methods was correlated with sonographic findings associated with increased risk of pump twin compromise. Fifty-nine pregnancies complicated by TRAP were identified. Using the prolate ellipsoid formula, the parabiotic twin mean sizes ± SD (as a percentage of pump twin weight) were 103.0% ± 52.0% and 56.9% ± 44.3% in cases with and without pump twin compromise (P = .0005), respectively. Using the sonographic Moore method, the mean parabiotic twin sizes were 122.9% ± 54.3% and 99.6% ± 62.8% in cases with and without pump twin compromise (P = .14). The median estimated masses of the parabiotic twin were 197 ± 219 g using the prolate ellipsoid formula and 310 ± 212 g using the sonographic Moore method (P = .0001). A parabiotic twin size greater than 70% of the pump twin correlated with findings associated with increased risk of pump twin compromise when using the prolate ellipsoid formula (P = .002) but not the sonographic Moore method (P = .09). Sonographic findings associated with increased risk of pump twin compromise correlate better with prolate ellipsoid estimates of parabiotic twin mass. The median estimated mass of the parabiotic twin was statistically larger when calculated by the sonographic Moore method than by the prolate ellipsoid formula.

Abstract 9689: Left Ventricular Mass Normalized to Lean Body Mass in Children May Obscure the Effect of Hypertension on the Heart

Purpose: In order to make comparisons of left ventricular mass (LVM) measurements among children, several methods of LVM normalization for body size have been developed. LVM has been hypothesized to correlate best with lean body mass (LBM). In addition, hypertension is a known risk factor for left ventricular hypertrophy. This study evaluates the agreement between LVM normalized to LBM (LVM L ) and LVM normalized to body surface area (LVM B ) or height (LVM H ). In addition the study evaluates the relationship between each method and systemic blood pressure. Our hypothesis is that LVM normalization to LBM will obscure the effect of hypertension on the LVM. Methods: Echocardiograms performed from 2009-2010 in 206 children (118 males, age 4 to 18 years) with no structural heart disease or systemic disorders other than hypertension and obesity were analyzed. LVM was calculated from M mode images using the prolate ellipsoid formula. LVM Z scores were calculated using 3 different published nomograms adjusting for height, BSA, and LBM. Intraclass correlation coefficients (ICC) with absolute agreement of single measures were used to assess concordance between LVM L Z score with the LVM B and LVM H Z scores. Pearson correlation was done to assess the associations. Results: Among the 206 patients, 21% had hypertension, 38% were obese, and 10% were obese and hypertensive. Mean BMI Z score was 1.1 ± 1.2, systolic BP Z score 0.6 ± 1.2, and diastolic BP Z score 0.1 ± 0.9. The ICC between LVM L and LVM B Z scores was 0.81 (95 th % CI: 0.73-0.86, p &lt; 0.001) and between LVM L and LVM H Z scores was 0.73 (95 th % CI: 0.29-0.87, p &lt; 0.001). Correlations of the 3 LVM Z scores with BP, weight, and BMI Z scores are shown in the table. Conclusion: LVM L has a better correlation with LVM B compared to LVM H . Elevated systolic BP associate with higher LVM H . There was no significant relationship between systolic BP and LVM L or LVM B , suggesting that these methods of LVM normalization may mask the effect of hypertension on LVM.

Pre-operative renal volume predicts peak creatinine after congenital heart surgery in neonates

Acute kidney injury is common in neonates following surgery for congenital heart disease. We conducted a retrospective analysis to determine whether neonates with smaller pre-operative renal volume were more likely to develop post-operative acute kidney injury. We conducted a retrospective review of 72 neonates who underwent congenital heart surgery for any lesion other than patent ductus arteriosus at our institution from January 2007 to December 2011. Renal volume was calculated by ultrasound using the prolate ellipsoid formula. The presence and severity of post-operative acute kidney injury was determined both by measuring the peak serum creatinine in the first 7 days post-operatively and by using the Acute Kidney Injury Network scoring system. Using a linear change point model, a threshold renal volume of 17 cm³ was identified. Below this threshold, there was an inverse linear relationship between renal volume and peak post-operative creatinine for all patients (p = 0.036) and the subgroup with a single morphologic right ventricle (p = 0.046). There was a non-significant trend towards more acute kidney injury using Acute Kidney Injury Network criteria in all neonates with renal volume ≤17 cm³ (p = 0.11) and in the subgroup with a single morphologic right ventricle (p = 0.17). Pre-operative renal volume ≤17 cm³ is associated with a higher peak post-operative creatinine and potentially greater risk for post-operative acute kidney injury for neonates undergoing congenital heart surgery. Neonates with a single right ventricle may be at higher risk.

A postmortem study on the volume of the human adrenal glands

Objective: A Cross-sectional descriptive type of study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2008 to June 2009, to see the variation in the volume of the adrenal glands with age in Bangladeshi people. Materials &amp; Methods: The study was performed on 140 post mortem human adrenal glands collected from 70 unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into four age-groups including group A (11-20 years), group B (21-30 years), group C (31-40 years) &amp; group D (41-60 years). The length, breadth and thickness of each adrenal gland were measured by using a slide calipers. Then the volume of each adrenal gland was determined by the product of its length, breadth and thickness multiplied by 0.52, according to the prolate ellipsoid formula. Results: The mean volume of the right adrenal glands were found 6.36±0.85 cm3 in group A (11-20 years), 6.49±0.76 cm3 in group B (21-30 years), 6.50±0.80 cm3 in group C (31-40 years), 6.76±0.79 cm3 in group D (41-60 years). The mean volume of the left adrenal glands were found 6.97±1.02 cm3 in group A (11-20 years),6.93 ±0.83 cm3 in group B (21-30 years), 6.65±0.79 cm3 in group C (31- 40 years), 7.09±0.81 cm3 in group D (41-60 years). The differences between the right and left adrenal glands and the difference between age groups were not statistically significant. Bangladesh Journal of Medical Science Vol. 12 No. 03 July ’13 Page 282-285 DOI: http://dx.doi.org/10.3329/bjms.v12i3.15425

993 PROSTATE TUMOR VOLUME IS INDEPENDENTLY ASSOCIATED WITH CANCER-SPECIFIC MORTALITY FOLLOWING RADICAL PROSTATECTOMY AND ENHANCES PATIENT RISK STRATIFICATION

You have accessJournal of UrologyProstate Cancer: Localized (IV)1 Apr 2013993 PROSTATE TUMOR VOLUME IS INDEPENDENTLY ASSOCIATED WITH CANCER-SPECIFIC MORTALITY FOLLOWING RADICAL PROSTATECTOMY AND ENHANCES PATIENT RISK STRATIFICATION John Knoedler, Robert Karnes, Laureano Rangel, Eric Bergstralh, and Stephen Boorjian John KnoedlerJohn Knoedler Rochester, MN More articles by this author , Robert KarnesRobert Karnes Rochester, MN More articles by this author , Laureano RangelLaureano Rangel Rochester, MN More articles by this author , Eric BergstralhEric Bergstralh Rochester, MN More articles by this author , and Stephen BoorjianStephen Boorjian Rochester, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.577AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Data regarding the independent prognostic significance of tumor volume (TV) are conflicting, and have focused on the outcome measure of biochemical recurrence. Moreover, whether TV improves estimation of prognosis beyond established predictive variables has not been established. Herein, we evaluated the association of TV with prostate cancer mortality following radical prostatectomy (RP), and assessed the additive prognostic value of TV to an established predictive model. METHODS We identified 13,687 patients who underwent RP without preoperative therapy at Mayo Clinic between 1987-2009. TV was estimated using the prolate ellipsoid formula. Cancer-specific survival (CSS) was estimated using the Kaplan Meier method and compared with the log-rank test. Cox proportional hazard regression models were used to evaluate the association of TV with mortality. The ability of TV to enhance the performance of the GPSM prognostic model [Blute et al, J Urol 2001] was assessed using the c-index. RESULTS Median TV was 1.57 cc (interquartile range (IQR) 0.48, 4.19). Increasing TV was associated with older patient age at surgery (p<0.0001), higher preoperative PSA (p<0.0001), smaller prostate volume (p=0.03), as well as higher pathologic Gleason score (p<0.0001), advanced pathologic tumor stage (p<0.0001), and an increased rate of positive surgical margins (p<0.0001). Median postoperative follow-up was 9.4 years (IQR 5.0, 14.5), during which time 3818 patients experienced BCR and 3138 died, including 430 who died of prostate cancer. Patient grouping into quartiles according to TV resulted in significant stratification of outcome, with a 15-year CSS by TV quartile of 99%, 98%, 95%, and 88%, respectively (p<0.001). On multivariate analysis (Table), TV remained associated with a significantly increased risk of death from prostate cancer (HR 1.29; p<0.0001). Addition of TV to the GPSM score increased the model's performance for prediction of prostate cancer mortality from 0.802 to 0.822. CONCLUSIONS TV is independently associated with survival following RP, and increases the performance of an established prediction model. As such, TV should be routinely included in RP pathology reports, and warrants testing in risk stratification tools. Multivariate analysis of factors associated with death from prostate cancer following radical prostatectomy. Variable HR 95% CI p Value Year of surgery 0.95 0.93-0.98 < 0.0001 Age at surgery 1.01 0.99-1.02 0.40 Preoperative PSA 0.95 0.87-1.04 0.26 Pathologic Gleason score 2.69 2.32-3.12 < 0.0001 Pathologic tumor stage 1.51 1.34-1.71 < 0.0001 pN+ 1.74 1.24-2.46 0.002 Positive surgical margin 1.26 1.02-1.58 0.04 Tumor volume 1.29 1.20-1.39 < 0.0001 Receipt of adjuvant RT 0.50 0.33-0.74 0.0006 Receipt of adjuvant ADT 0.61 0.44-0.84 0.002 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e407 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Knoedler Rochester, MN More articles by this author Robert Karnes Rochester, MN More articles by this author Laureano Rangel Rochester, MN More articles by this author Eric Bergstralh Rochester, MN More articles by this author Stephen Boorjian Rochester, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Heart rate changes mediate the embryotoxic effect of antiarrhythmic drugs in the chick embryo

A significant increase in cardiovascular medication use during pregnancy occurred in recent years. Only limited evidence on safety profiles is available, and little is known about the mechanisms of adverse effect on the fetus. We hypothesized that drug-induced bradycardia is the leading mechanism of developmental toxicity. Embryotoxicity was tested in ovo after administration of various doses of metoprolol, carvedilol, or ivabradine. Embryonic day (ED) 4 and 8 chick embryos were studied by video microscopy and ultrasound biomicroscopy ex ovo after intraamniotic injection of the drug for a period of 30 min. Stroke volume was calculated by the Simpson method and prolate ellipsoid formula. Significant dose-dependent mortality was achieved in embryos injected with carvedilol and ivabradine. In ED4 embryos, metoprolol, carvedilol, and ivabradine reduced the heart rate by 33%, 27%, and 55%, respectively, compared with controls (6%). In ED8 embryos this effect was more pronounced with a heart rate reduction by 71%, 54%, and 53%, respectively (controls, 36%). Cardiac output decreased in all tested groups but only proved significant in the metoprolol group in ED8 embryos. The number of β-adrenergic receptors showed a downward tendency during embryonic development. A negative chronotropic effect of metoprolol, carvedilol, and ivabradine was increasingly pronounced with embryonic maturity despite a downward trend in the number of β-adrenergic receptors. This effect was associated with reduced cardiac output in chick embryos, probably leading to premature death. Although standard doses of these drugs appear relatively safe, high doses have a potentially adverse effect on the fetus through reduced heart rate.

ESTIMATION OF FELINE RENAL VOLUME USING COMPUTED TOMOGRAPHY AND ULTRASOUND

Renal volume estimation is an important parameter for clinical evaluation of kidneys and research applications. A time efficient, repeatable, and accurate method for volume estimation is required. The purpose of this study was to describe the accuracy of ultrasound and computed tomography (CT) for estimating feline renal volume. Standardized ultrasound and CT scans were acquired for kidneys of 12 cadaver cats, in situ. Ultrasound and CT multiplanar reconstructions were used to record renal length measurements that were then used to calculate volume using the prolate ellipsoid formula for volume estimation. In addition, CT studies were reconstructed at 1 mm, 5 mm, and 1 cm, and transferred to a workstation where the renal volume was calculated using the voxel count method (hand drawn regions of interest). The reference standard kidney volume was then determined ex vivo using water displacement with the Archimedes' principle. Ultrasound measurement of renal length accounted for approximately 87% of the variability in renal volume for the study population. The prolate ellipsoid formula exhibited proportional bias and underestimated renal volume by a median of 18.9%. Computed tomography volume estimates using the voxel count method with hand-traced regions of interest provided the most accurate results, with increasing accuracy for smaller voxel sizes in grossly normal kidneys (-10.1 to 0.6%). Findings from this study supported the use of CT and the voxel count method for estimating feline renal volume in future clinical and research studies.

Ultrasonographically Calculated Uterine Volume as a Predictor for Surgical Outcomes in Total Laparoscopic Hysterectomy

Abstract Background: With more laparoscopic hysterectomies being performed for increasingly large uteri, prediction of surgical outcomes is becoming more important. There is a paucity of information regarding preoperative predictors of surgical outcomes in the large uterus that could be helpful in perioperative planning. Objective: The aim of this research was to examine the predictive value of ultrasonographically-measured uterine mass on surgical outcomes in total laparoscopic hysterectomy (TLH). Materials and Methods: This was a retrospective exploratory study analyzing surgical outcomes following TLH over a 15-year period. Subjects were recruited in four San Francisco area hospitals. For 1004 patients, data were collected regarding demographics, ultrasonographically measured uterine volumes, and surgical outcomes (operative time, estimated blood loss [EBL], length of hospital stay, and postoperative uterine mass). Uterine mass was calculated using the prolate ellipsoid formula and a volume-to-mass con...

Ovarian cancer: role of ultrasound in preoperative diagnosis and population screening

Ovarian cancer: role of ultrasound in preoperative diagnosis and population screening