Measurement of Prostate Volume with MRI (A Guide for the Perplexed): Biproximate Method with Analysis of Precision and Accuracy

Neil F. Wasserman, Eric Niendorf, Benjamin Spilseth

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


To review the anatomic basis of prostate boundary selection on T2-weighted magnetic resonance imaging (MRI). To introduce an alternative 3D ellipsoid measuring technique that maximizes precision, report the intra- and inter-observer reliability, and to advocate it’s use for research involving multiple observers. We demonstrate prostate boundary anatomy using gross pathology and MRI examples. This provides background for selecting key boundary marks when measuring prostate volume. An alternative ellipsoid volume method is then proposed using these boundaries in an attempt to improve inter-observer precision. An IRB approved retrospective study of 140 patients with elevated serum prostate specific antigen levels and/or abnormal digital rectal examinations was done with T2-weighted MRI applying a new (Biproximate) technique. Measurements were made by 2 examiners, correlated with each other for inter-observer precision and correlated with an expert observer for accuracy. Correlation statistics, linear regression analysis, and tests of means were applied using p ≤ 0.05 as the threshold for significance. Inter-observer correlation (precision) was 0.95 between observers. Correlation between these observers and the expert (accuracy) was 0.94 and 0.97 respectively. Intra-observer correlation for the expert was 0.98. Means for inter-rater reliability and accuracy were all the same (p = 0.001). We conclude that using more precise reproducible landmarks with biproximate technique, precision and accuracy of total prostate volume is found to be demonstrated.

Original languageEnglish (US)
Article number575
JournalScientific reports
Issue number1
StatePublished - Jan 17 2020

Bibliographical note

Publisher Copyright:
© 2020, The Author(s).


  • Adult
  • Aged
  • Digital Rectal Examination
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Observer Variation
  • Prostate/diagnostic imaging
  • Prostatic Neoplasms/diagnostic imaging
  • Radiographic Image Interpretation, Computer-Assisted/methods
  • Retrospective Studies
  • Sensitivity and Specificity

PubMed: MeSH publication types

  • Journal Article


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