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Appropriateness Criteria

Reference Study Type Patients/Events Study Objective(Purpose of Study) Study Results Study Quality
1. Gratzke C, Bachmann A, Descazeaud A, et al. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. [Review]. Eur Urol. 67(6):1099-109, 2015 Jun. Review/Other-Dx N/A To develop European Association of Urology (EAU) guidelines on the assessment of men with non-neurogenic LUTS. No results stated in abstract. 4
2. Hecht SL, Hedges JC. Diagnostic Work-Up of Lower Urinary Tract Symptoms. [Review]. Urol Clin North Am. 43(3):299-309, 2016 Aug. Review/Other-Dx N/A To discuss the work-up of lower urinary tract symptoms (LUTS) based off of multiple clinical practice guidelines. No results stated in abstract. 4
3. Egan KB.. The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates. [Review]. Urol Clin North Am. 43(3):289-97, 2016 Aug. Review/Other-Dx N/A To assess the full body of published literature in regard to benign prostatic hyperplasia (BPH)/ lower urinary tract symptoms (LUTS) estimates as well as to determine if the differences reported by disease severity, age, and race/ethnicity are consistent between studies and/or comparable. BPH/LUTS prevalence rates ranged from 50% to 75% among men 50 years of age and older to 80% among men 70 years of age and older. Overall incidence rates ranged from 8.5 to 41 cases/1000 person–years. 4
4. Bosch JL, Bohnen AM, Groeneveld FP. Validity of digital rectal examination and serum prostate specific antigen in the estimation of prostate volume in community-based men aged 50 to 78 years: the Krimpen Study. European Urology. 46(6):753-9, 2004 Dec.Eur Urol. 46(6):753-9, 2004 Dec. Observational-Dx 1688 men To determine how well digital rectal examination (DRE) and serum prostate specific antigen (PSA), in comparison to planimetric transrectal ultrasonometry (TRUS), can estimate whether the prostate is enlarged as defined by PV above or below a certain cut-off value (30, 40, 50 cc) in community-based men aged 50 to 78 years. The AUC values of the receiver-operating curves (ROC) curves for serum PSA as a method for the discrimination of prostate volumes above or below 30, 40 and 50 cc are 0.79, 0.86 and 0.92, respectively. DRE has limited value in the estimation of prostate volume and is only good in identifying very large prostates (>50 cc). 3
5. El-Zawahry A, Alanee S, Malan-Elzawahry A. The Use of Urodynamics Assessment Before the Surgical Treatment of BPH. [Review]. Curr Urol Rep. 17(10):73, 2016 Oct. Review/Other-Tx N/A To discuss the use of urodynamics assessment to improve quality of treatment, optimize counseling, and improve treatment outcomes of benign prostate hyperplasia (BPH). No results stated in abstract. 4
6. Oelke M, Bachmann A, Descazeaud A, et al. EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. [Review]. Eur Urol. 64(1):118-40, 2013 Jul. Review/Other-Tx N/A To present a summary of the 2013 version of the European Association of Urology guidelines on the treatment and follow-up of male lower urinary tract symptoms (LUTS). No results stated in abstract. 4
7. Kuang M, Vu A, Athreya S. A Systematic Review of Prostatic Artery Embolization in the Treatment of Symptomatic Benign Prostatic Hyperplasia. [Review]. Cardiovasc Intervent Radiol. 40(5):655-663, 2017 May. Review/Other-Tx Ten studies representing 788 patients To summarize current evidence on outcomes and complications of prostatic artery embolization as a treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The search yielded 193 articles, of which ten studies representing 788 patients, with a mean age of 66.97 years, were included. Patients had LUTS ranging from moderate to severe. At 6 months following procedure, PV, PVR, Qmax, IPSS, and QoL were significantly improved (P < 0.05), while for PSA there was no significant change. At 12 and 24 months, PV, PSA, PVR, Qmax, IPSS, and QoL were significantly improved (P < 0.05). IIEF was unchanged at 6 and 12 months but was significantly reduced at 24 months. 4
8. Porter T, Stoddart G, Hinchliffe A. The role of the plain X-ray in the assessment of prostatic symptoms. Br J Urol. 81(2):257-8, 1998 Feb. Review/Other-Dx 292 patients To assess the contribution of a plain X-ray of the kidney, ureters and bladder (KUB) to the assessment of patients presenting with symptoms of bladder outlet obstruction. Of the 292 patients, 234 had no relevant abnormality detected: four patients had evidence of a bladder calculus, whilst in four osteosclerotic areas were noted on the pelvis and lumbar spine. Of the remainder, 14 (5%) had upper urinary tract calcification. In no patients did the KUB influence their immediate management. Those with asymptomatic upper tract stones were offered a yearly follow-up. 4
9. Stacul F, Rossi A, Cova MA. CT urography: the end of IVU? Radiol Med. 2008;113(5):658-669. Review/Other-Dx N/A Review literature comparing diagnostic accuracy of MDCTU and IVU. MDCTU has a high diagnostic accuracy. 4
10. Little MA, Stafford Johnson DB, O'Callaghan JP, Walshe JJ. The diagnostic yield of intravenous urography. Nephrol Dial Transplant. 15(2):200-4, 2000 Feb. Observational-Dx 200 patients (114 females and 86 males) To examine prospectively, and in a blinded fashion, the diagnostic yield in an unselected cohort of patients referred for intravenous urography (IVU) in a large teaching hospital and to question whether access to this investigation should be limited. Overall, 23% of tests were positive. There was a highly significant difference in diagnostic yield between the groups (P<0.001 for both referral source and test indication). A positive result was most likely after referral by a kidney specialist (37.1%) and when the test indication was renal colic (42%) or haematuria (32%). The yield was <15% in all other circumstances, with 94.9% and 92.1% of GP- and other hospital speciality-initiated IVUs being negative. When investigating recurrent UTI, 91.7% of tests were negative and 86.2% were negative when the indication was bladder outflow obstruction. 2
11. Wasserman NF, Lapointe S, Eckmann DR, Rosel PR. Assessment of prostatism: role of intravenous urography. Radiology. 1987;165(3):831-835. Observational-Dx 502 patients Prospective study of patients referred for assessment of symptoms of bladder outlet obstruction was performed to determine the value of routine IVU. Abnormalities were found in 23% of patients but significant conditions in only 10%. Occult significant abnormalities that would have been missed without IVU occurred in only 1.5% of patients. Most of these could be detected on an abdominal radiograph. Only one malignancy would have been missed without routine IVU. The authors conclude that IVU in the assessment of prostatism should be limited to patients with positive findings in the clinical workup. An abdominal radiograph is recommended in the others. Significant cost savings can thus be achieved. 3
12. O'Connor OJ, Fitzgerald E, Maher MM. Imaging of hematuria. [Review]. AJR Am J Roentgenol. 195(4):W263-7, 2010 Oct. Review/Other-Dx N/A To discuss the current status of imaging in patients with hematuria of urologic origin. No results stated in abstract. 4
13. Ahmad S, Manecksha RP, Cullen IM, et al. Estimation of clinically significant prostate volumes by digital rectal examination: a comparative prospective study. Can J Urol. 18(6):6025-30, 2011 Dec. Observational-Dx 248 patients To determine the reliability of digital rectal examination (DRE) in estimation of prostate volume which may be helpful in patient selection for 5 alpha-reductase inhibitors (5-ARIs) therapy. Comparative analysis of prostate volume (n = 248) by DRE and TRUS was performed. There was no significant difference between DRE-estimated prostate volume at the first and second examinations (p = 0.8). DRE-estimated volumes for prostates categorized as small, medium or large were underestimated in 59%, 58% and 53% of patients respectively. However, for clinical relevant volumes (> 30 cc), 94.5% patients were accurately estimated on DRE. 2
14. Stravodimos KG, Petrolekas A, Kapetanakis T, et al. TRUS versus transabdominal ultrasound as a predictor of enucleated adenoma weight in patients with BPH: a tool for standard preoperative work-up?. Int Urol Nephrol. 41(4):767-71, 2009 Dec. Observational-Dx 71 patients To evaluate transrectal ultrasonography (TRUS) as a standard tool in the evaluation of patients with benign prostate hyperplasia (BPH) with a special focus on the potential impact it might have on the decision of open versus transurethral surgery. TRUS slightly underestimated W by 4.4% (95% CI 10.5, 1.7) while transabdominal ultrasound overestimated it by 55.7% (95% CI 31.8, 79.6). Regression analysis indicated TRUS as a better predictor of W (R (2) = 0.817, P < 0.0005) followed by transabdominalultrasound (R (2) = 0.669, P < 0.0005). Strictly based on European Association of Urology (EAU) criteria, transabdominal measurements miscategorized 25 cases by falsely assigning them to the open surgery (>80 cc) group while TRUS did so for four cases. 3
15. Yuen JS, Ngiap JT, Cheng CW, Foo KT. Effects of bladder volume on transabdominal ultrasound measurements of intravesical prostatic protrusion and volume. Int J Urol. 9(4):225-9, 2002 Apr. Review/Other-Dx 22 patients To evaluate the effects of bladder volume on transabdominal ultrasound measurements of intravesical prostatic protrusion and volume parameters. There was an obvious trend of decreasing mean transabdominal intravesical prostatic protrusions with increasing bladder volume. The mean transabdominal intravesical prostatic protrusion at bladder volumes 100, 200, 300, 400 and 500 mL was 9.1, 8.8, 7.4, 5.8 and 4.6 mm, respectively. The bladder volume at which maximum prostatic protrusion occurred was between 100 and 200 mL. The mean transabdominal prostate volume at the five increasing bladder volumes was 50.6, 48.7, 49.2, 47.9 and 41.4 mL, and these were correlated to transrectal prostate volume, particularly when the bladder volume was less than 400 mL. 4
16. Tatar IG, Ergun O, Celtikci P, Birgi E, Hekimoglu B. Value of prostate gland volume measurement by transrectal US in prediction of the severity of lower urinary tract symptoms. Med. ultrasonography. 16(4):315-8, 2014 Dec. Observational-Dx 101 patients To analyze the value of prostate gland volume measurement by transrectal ultrasonography (TRUS) in prediction of severity of lower urinary tract symptoms (LUTS). There was a significant but low correlation of 0.37 between International Prostate Symptom Score (IPSS) and prostate volume measurement by TRUS (p=0.001). Serum free prostate specific antigen (fPSA), total PSA (tPSA), ratio of fPSA to tPSA and PSA density did not show a statistically significant correlation with IPSS (p>0.05). No statistically significant difference in IPSS between the benign and malignant groups (p=0.681) was found. In the benign group, mean IPSS was 14.59 ± 8.73, range: 0-35 while in the malignant group, mean IPSS was 15.33 ± 9.22, range: 3-28. 3
17. Danish Qaseem SM, Ghonge NP, Aggarwal B, Singhal S. Prospective evaluation of prostate with transrectal spectral Doppler with biopsy correlation: a clinicopathologic study. Br J Radiol. 89(1060):20150830, 2016. Observational-Dx 55 patients To compare the transrectal (TR) spectral Doppler findings between benign prostatic hyperplasia group and prostate cancer group. The mean values of resistive index (RI), pulsatality index (PI), systolic/diastolic ratio (S/D) and peak systolic velocity (PSV) were found to be 0.84/1.03, 1.8/1.99, 3.93/4.45 and 15.52/16.15cm s-1, respectively, in the control and study groups which were not statistically significant. In patients with unilateral malignancy (n = 16), there was no significant difference from the non-tumour side. Doppler parameters showed statistically significant relationships with age. The mean of minimum RI was found to be 0.60 in patients less than 60 years of age and 0.76 in patients more than or equal to 60 years of age in the benign category (p-value = 0.014). The PI and S/D also showed significant difference in the benign category. 3
18. Shinbo H, Kurita Y. Application of ultrasonography and the resistive index for evaluating bladder outlet obstruction in patients with benign prostatic hyperplasia. [Review]. Curr Urol Rep. 12(4):255-60, 2011 Aug. Review/Other-Dx N/A To see if transrectal ultrasonography (TRUS) imaging is capable of measuring the resistive index for evaluating bladder outlet obstruction (BOO) and for determining proper medical intervention in patients suffering from benign prostatic hyperplasia (BPH). No results stated in abstract. 4
19. Foo KT.. Decision making in the management of benign prostatic enlargement and the role of transabdominal ultrasound. [Review]. Int J Urol. 17(12):974-9, 2010 Dec. Review/Other-Dx N/A To decision make in the management of benign prostatic enlargement and the role of transabdominal ultrasound. No results stated in abstract. 4
20. Kuo TL, Teo JS, Foo KT. The role of intravesical prostatic protrusion (IPP) in the evaluation and treatment of bladder outlet obstruction (BOO). Neurourol Urodyn. 35(4):535-7, 2016 Apr. Review/Other-Dx N/A To understand the role of intravesical prostatic protrusion (IPP) in the evaluation and treatment of bladder outlet obstruction (BOO). IPP has been shown to have a positive predictive value of 72% for BOO. It has been calculated to have an area under curve (AUC) value of 0.71 and 0.84 in some studies. Clinically, it may be used to predict the outcome of a trial without catheter following acute retention of urine. Patients with higher IPP grade were noted to have a higher risk of clinical progression. Studies have also shown that men with higher IPP are poorer responders to medical treatment such as a-blockers. 4
21. Nose H, Foo KT, Lim KB, Yokoyama T, Ozawa H, Kumon H. Accuracy of two noninvasive methods of diagnosing bladder outlet obstruction using ultrasonography: intravesical prostatic protrusion and velocity-flow video urodynamics. Urology. 65(3):493-7, 2005 Mar. Observational-Dx 168 male patients To assess the accuracy of two noninvasive, ultrasound methods of diagnosing bladder outlet obstruction (BOO). The potential for the combined methods to enhance the accuracy of diagnosis was also assessed. Intravesical prostatic protrusion (IPP) grading correlated well with the BOO index (Spearman’s rho 0.624), as did the Doppler UDS parameter (Spearman’s rho 0.736). The combination of IPP grading and Doppler UDS showed good sensitivity and specificity. 1
22. Chiang Po, Chuang YC, Huang CC, Chiang CP. Pilot study of transperineal injection of dehydrated ethanol in the treatment of prostatic obstruction. Urology. 61(4):797-801, 2003 Apr. Observational-Tx 11 patients To evaluate the efficacy of a new approach for treatment of prostatic obstruction involving transperineal injection of dehydrated ethanol into the prostate using transrectal ultrasound (TRUS). There were no intraoperative complications, but postoperative urinary retention occurred in 1 patient who received catheterization for 3 days. The mean symptom score decreased from 17.7 ± 6.0 (median 23) to 8.5 ± 1.1 (median 3.5) at 3 months postoperatively (P ± 0.01); mean peak urine flow rate increased from 5.3 ± 4.0 mL/s (median 7) to 13.5 ± 3.6 mL/s (median 14) (P ± 0.05); and mean residual urine volume decreased from 231.9 ± 209.8 mL (median 108) to 28.7 ± 13.7 mL (median 34) (P ± 0.01). There were no significant differences at 6 months when the same parameters were assessed. Pathologic findings for 2 patients with prostatic obstruction due to carcinoma showed only granulation tissue, with no evidence of malignancy in the treated area. 1
23. Tan YH, Foo KT. Intravesical prostatic protrusion predicts the outcome of a trial without catheter following acute urine retention. J Urol. 170(6 Pt 1):2339-41, 2003 Dec. Observational-Tx 100 male patients To prospectively evaluate a simple, noninvasive method to predict the outcome of a voiding trial following acute urine retention (ARU) based on intravesical prostatic protrusion (IPP) using transabdominal ultrasound. The failure rate of the voiding trial based on grades 1 to 3 intravesical prostatic protrusion (IPP) were 36% (13 of 36 cases), 58% (11 of 19) and 67% (30 of 45). This rate was significant (chi-square test for trend 0.007). 2
24. Wang D, Huang H, Law YM, Foo KT. Relationships between Prostatic Volume and Intravesical Prostatic Protrusion on Transabdominal Ultrasound and Benign Prostatic Obstruction in Patients with Lower Urinary Tract Symptoms. Ann Acad Med Singapore. 44(2):60-5, 2015 Feb. Observational-Dx 408 male patients To determine the relationships between prostatic volume (PV) and intravesical prostatic protrusion (IPP) with benign prostatic obstruction (BPO). There was a fair positive correlation between the PV and IPP (Spearman, rs = 0.62, P <0.001) with important clinical exceptions. There was negative correlation between the PV and Qmax (rs = -0.20, P = 0.022), IPP and Qmax (rs = -0.30, P <0.001). PV and IPP were good predictors of BPO. However, IPP was slightly better (rs of -0.30 vs -0.20) than PV. 3
25. Ahmed AF.. Sonographic Parameters Predicting the Outcome of Patients With Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia Treated With Alpha1-Adrenoreceptor Antagonist. Urology. 88:143-8, 2016 Feb. Observational-Dx 166 patients To define prostate and bladder sono-morphologic parameters that best predict the outcome of benign prostatic hyperplasia (BPH) in men treated with alpha1-adrenoreceptor antagonist. A total of 166 patients completed the study. From these, 59 (35.5%) had ineffective treatment after 6 months. According to logistic regression analysis, baseline International Prostatic Symptom Score storage subscore, maximum urine flow rate, and transrectal ultrasonography-measured sonomorphologic parameters (bladder wall thickness [BWT], ultrasound estimated bladder weight [UEBW], and intravesical prostatic protrusion [IPP]) were the independent predictors of ineffective treatment (P < .05). Using receiver operating characteristics analysis, BWT, UEBW, and IPP had adequate area under the curve (0.939, 0.897, and 0.876, respectively). At cutoff values of 9.3 mm, 34.5 g, and 12.9 mm, the positive and negative predictive values for BWT, UEBW, and IPP were 83.6% and 92.4%; 78.2% and 85.6%; 80.3% and 90.5%; respectively. Combination of these sono-morphologic parameters increased their positive predictive value to 97.6%. Combination of these sono-morphologic parameters increased their positive predictive value to 97.6%. 3
26. Shin SH, Kim JW, Kim JW, Oh MM, Moon du G. Defining the degree of intravesical prostatic protrusion in association with bladder outlet obstruction. Korean J Urol. 54(6):369-72, 2013 Jun. Observational-Dx 239 patients To define the degree of intravesical prostatic protrusion (IPP) causing bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms. There were significant differences in total prostate volume, postvoiding residual urine (PVR), IPP, and Qmax (p<0.001, p<0.001, p<0.001, and p=0.026, respectively) between the obstructed and unobstructed groups, but there were no significant differences in age (p=0.653), IPSS total score (p=0.624), or quality of life score (p=0.138). IPP had a significant prognosis (p<0.001) but was weakly correlated with prostate volume (p=0.026). The correlation coefficients between IPP and Qmax, PVR, prostate volume, and BOO were 0.551, -0.159, 0.225, and 0.391, respectively. For IPP, the area under the curve was 0.759 (95% confidence interval, 0.657 to 0.861) and the cutoff to indicate BOO was 5.5 mm with 66.7% sensitivity and 80.5% specificity. 3
27. Suzuki T, Otsuka A, Ozono S. Combination of intravesical prostatic protrusion and resistive index is useful to predict bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Int J Urol. 23(11):929-933, 2016 Nov. Observational-Dx 350 patients To examine which parameters obtained from transrectal ultrasonography are accurate predictors of urodynamically-confirmed bladder outlet obstruction in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Bladder outlet obstruction index positively correlated with intravesical prostatic protrusion, total prostate volume, transition zone volume, transition zone index, resistive index and prostate-specific antigen. Further, resistive index was only a significant independent variable with intravesical prostatic protrusion. Intravesical prostatic protrusion had the highest area under the curve of 0.790 among all variables, and its cut-off value was 10 mm. The positive predictive value of intravesical prostatic protrusion was 76.2%. In addition, the positive predictive value of the combined parameters intravesical prostatic protrusion and resistive index increased to 83.8%. 3
28. Arnolds M, Oelke M. Positioning invasive versus noninvasive urodynamics in the assessment of bladder outlet obstruction. [Review] [57 refs]. Curr Opin Urol. 19(1):55-62, 2009 Jan. Review/Other-Dx N/A To provide evidence of promising tests to noninvasively diagnose bladder outlet obstruction (BOO) in men with benign prostatic hyperplasia. Pressure-flow studies are usually performed to prove BOO prior to prostatectomy. However, pressure-flow studies are invasive, expensive, time consuming, and potentially harmful to the patient due to unwarranted side-effects. In the last decade, attempts were made to diagnose BOO noninvasively. Ultrasound-derived measurements such as bladder or detrusor wall thickness or intravesical prostatic protrusion and urodynamic-derived measurements such as isovolumetric bladder pressure by the condom catheter or penile cuff tests show promising results. Likelihood ratios of all tests were calculated for this study and indicated a good ability to detect BOO. 4
29. Ho CC, Ngoo KS, Hamzaini AH, Rizal AM, Zulkifli MZ. Urinary bladder characteristics via ultrasound as predictors of acute urinary retention in men with benign prostatic hyperplasia. Clin Ter. 165(2):75-81, 2014. Observational-Dx 79 patients To determine the clinical utility of urinary bladder and prostate characteristics measured by ultrasound scan in predicting acuteurinary retention (AUR) for men with bladder outlet obstruction with an underlying benign prostate hyperplasia (BPH). Among selected patients, thirty had acuteurinary retention (AUR) while 32 men presented with lower urinary tract symptoms (LUTS) only. There were significant differences between those with and without AUR in their age (70.5 vs 66.0, p=0.017), international prostatic symptom score (IPSS) (24.0 vs 18.5, p=0.009), serum prostate-specific antigen (PSA) (6.18 vs 1.77, p=0.002), prostatic volume (PV) (56.7 vs 32.4, p=0.006), bladder wall thickness (5.0 vs 4.4, p=0.034) and estimated bladder weight  (UEBW) (39.1 vs 25.0, p=0.0003). Multivariate analysis revealed high IPSS and UEBW to be predictors for AUR. UEBW was the strongest predictor of AUR: area under ROC curve was 0.767, with sensitivity and specificity of 63.3% and 87.5%, respectively, at cut-off point of 35g. The likelihood ratio for AUR was also best with UEBW=35g. 3
30. Miyashita H, Kojima M, Miki T. Ultrasonic measurement of bladder weight as a possible predictor of acute urinary retention in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Ultrasound Med Biol. 28(8):985-90, 2002 Aug. Observational-Dx 160 male patients To test the clinical utility of ultrasonic measurement of bladder weight as a predictor of acute urinary retention (AUR) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH). 31 male patients (19.4%) presented to our clinic with acute urinary retention (AUR). From the thickness of the anterior bladder wall measured by transabdominal ultrasonography and the intravesical volume, estimated bladder weight (UEBW) was calculated, supposing the bladder to be a sphere. Between patients with and without AUR, there were significant differences for age (75.4 vs. 71.1 years, p < 0.005), prostatic volume (45.5 vs. 35.8 g, p < 0.05), transition zone (TZ) volume (29.4 vs. 20.2 g, p < 0.05), TZ index (0.606 vs. 0.493, p < 0.005) and UEBW (50.3 vs. 34.7 g, p < 0.0001). A receiver-operating characteristic curve analysis demonstrated UEBW to be superior to the other prostatic ultrasonic measures in identifying AUR. Patients with lower urinary tract symptoms (LUTS) suggestive of BPH having UEBW greater than 35.0 g were 13.4 times as likely to suffer from AUR. 3
31. Grossfeld GD, Coakley FV. Benign prostatic hyperplasia: clinical overview and value of diagnostic imaging. [Review] [70 refs]. Radiol Clin North Am. 38(1):31-47, 2000 Jan. Review/Other-Dx N/A Clinical overview and diagnostic imaging of BPH. Routine upper tract imaging not indicated in patients with lower urinary tract symptoms. Local imaging of prostate can be performed with TRUS or MRI. 4
32. Kang TW, Song JM, Kim KJ, et al. Clinical application of computed tomography on prostate volume estimation in patients with lower urinary tract symptoms. Urol. j.. 11(6):1980-3, 2014 Nov 30. Observational-Dx 107 patients To compare estimated prostate volume (PV) based on computed tomography (CT) scan and transrectal ultrasonography (TRUS) in patients with lower urinary tract symptoms (LUTS). Mean prostate volume computed tomography (PVCT) ellipsoid was 40.63 ± 31.06 cm3 (range, 8.34-217.46). Mean prostate volume transrectal ultrasonography (PVTRUS) and PVCT 3D reconstruction were 39.20 ± 33.04 (range, 4.00-223.81) and 45.30 ± 32.98 (range, 8.90-248.30), respectively. PVCT ellipsoid was highly correlated with PVTRUS and PVCT 3D reconstruction (r = 0.935, P < .001; r = .970, P< .001, respectively). Moreover, there was very strong agreement for PV measurements with all three methods (intraclass correlation coefficient = 0.934, P < .001). 2
33. Expert Panel on Urologic Imaging:, Coakley FV, Oto A, et al. ACR Appropriateness Criteria R Prostate Cancer-Pretreatment Detection, Surveillance, and Staging. [Review]. J. Am. Coll. Radiol.. 14(5S):S245-S257, 2017 May. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for prostate cancer, pretreatment detection, surveillance and staging. No results stated in abstract. 4
34. Guneyli S, Ward E, Thomas S, et al. Magnetic resonance imaging of benign prostatic hyperplasia. Diagn Interv Radiol. 22(3):215-9, 2016 May-Jun. Review/Other-Dx N/A To retrospectively evaluate MRI images of Benign Prostatic Hyperplasia (BPH) patients who were histologically diagnosed and present different types of BPH on MRI. No results stated in abstract 4
35. Turkbey B, Huang R, Vourganti S, et al. Age-related changes in prostate zonal volumes as measured by high-resolution magnetic resonance imaging (MRI): a cross-sectional study in over 500 patients. BJU Int. 110(11):1642-7, 2012 Dec. Observational-Dx 503 patients To utilize ability of magnetic resonance imaging (MRI) to investigate age related changes in zonal prostatic volumes. Linear regression analysis demonstrated positive correlation between WP, CG volumes and patient age (p<0.0001); there was no correlation between age and PZ volume (p=0.173). There was positive correlation between WP, CG volumes and serum PSA (p<0.0001), as well as between PZ volume and serum PSA (p=0.0021). At logistic regression analysis, IPSS positively correlated with WP, CG volumes (p<0.0001). SHIM positively correlated with WP (p<0.0149), CG(p<0.0234) volumes. As expected, IPSS of patients with prostate volumes (WP, CG) in 1st decile for age were significantly lower than those in 10th decile. 3
36. Guneyli S, Ward E, Peng Y, et al. MRI evaluation of benign prostatic hyperplasia: Correlation with international prostate symptom score. Journal of Magnetic Resonance Imaging. 45(3):917-925, 2017 Mar.J Magn Reson Imaging. 45(3):917-925, 2017 Mar. Observational-Dx 61 patients To investigate the correlation between magnetic resonance imaging (MRI)-derived prostate parameters and benign prostatic hyperplasia (BPH) type with the International Prostate Symptom Score (IPSS). TPV (r=0.414, P=0.001), TZV (r=0.405, P=0.001), IPP (r=0.270, P=0.04), and AFMS distance (r=0.363, P=0.004) correlated with total IPSS. In multiple linear regression analysis, TZV was the only predictor for total IPSS (P=0.001), IPSS-ss (P < 0.001), IPSS-vs (P=0.03), and the scores for the IPSS questions 1 (P=0.03) and 4 (P=0.001). TPV was a predictor of the scores for questions 2 (P=0.003), 3 (P=0.009), and 7 (P < 0.001). 2
37. Wasserman NF, Spilseth B, Golzarian J, Metzger GJ. Use of MRI for Lobar Classification of Benign Prostatic Hyperplasia: Potential Phenotypic Biomarkers for Research on Treatment Strategies. AJR Am J Roentgenol. 205(3):564-71, 2015 Sep. Review/Other-Dx 313 male patients To determine the use of MRI classification of benign prostatic hyperplasia (BPH) as a phenotype biomarker in the study of proposed therapeutic interventions. No results stated in abstract. 4
38. Kasivisvanathan V, Rannikko AS, Borghi M, et al. MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med. 378(19):1767-1777, 2018 May 10. Experimental-Dx 500 men To compare MRI-targeted biopsy with standard transrectal ultrasonography–guided biopsy in a pragmatic, multicenter, randomized trial. A total of 500 men underwent randomization. In the MRI-targeted biopsy group, 71 of 252 men (28%) had MRI results that were not suggestive of prostate cancer,so they did not undergo biopsy. Clinically significant cancer was detected in 95 men (38%) in the MRI-targeted biopsy group, as compared with 64 of 248 (26%) in the standard-biopsy group (adjusted difference, 12 percentage points; 95% confidence interval [CI], 4 to 20; P = 0.005). MRI, with or without targeted biopsy, was non inferior to standard biopsy, and the 95% confidence interval indicated the superiority of this strategy over standard biopsy. Fewer men in the MRI-targeted biopsy group than in the standard-biopsy group received a diagnosis of clinically insignificant cancer (adjusted difference, -13 percentage points; 95% CI, -19 to -7; P<0.001). 2
39. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Appropriateness-Criteria/ACR-Appropriateness-Criteria-Radiation-Dose-Assessment-Introduction.pdf. Review/Other-Dx N/A To provide evidence-based guidelines on exposure of patients to ionizing radiation. No abstract available. 4
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