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What Does The Following CT Scan Of Prostate Indicate?

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Posted on Fri, 19 Dec 2014
Question: Hi, can prostate measurement using USG and CT differ by 20cc! Using USG it is 42cc while using CECT it is 63cc. Which one is more authentic? No symptom felt like no problem while urinating, no pain and with 8cc postvoid found in USG.

Relevant observations are:
Normocytic normochromic blood picture with mild neutrophilia (Ob : 77, Ref : 40-75)
Occasional epithelial cells (Ob : 1-2, Ref : 0-2)
Prostate volume 42.7 cc (USG)
Urinary Bladder Postvoid : 8cc (USG)
Lymphocytes (Ob : 18, Ref : 20-45)
Urea (Ob : 14, Ref : 15-45)
Alkaline Phosphatase (Ob : 154, Ref : 56-119)
Acid Phosphatase Prostatic Fraction (Ob : 5, Ref : <3)
Pus cells (Ob : 1-2, Ref : 0-2)
Vitamin D [25 hydroxy Vitamin D] (Ob : 17.9, Ref : 31-100)

Result of CT scan:
Prostate is grossly enlarged in size & measures 5.6 x 4.5 x 5.0cms (Vol-63cc). The enlarged median lobe is bulging into the base of urinary bladder. Periprostatic fat planes are normal.

doctor
Answered by Dr. Indu Kumar (40 minutes later)
Brief Answer:
USG is more accurate especially TRUS.

Detailed Answer:
Hello XXXXXXX

USG is ideal for estimating prostate volume.CT tends to overestimate prostate volume.However,both readings suggests enlarged prostate in your case.

Transrectal ultrasonography(TRUS) is ideal for estimation of prostate volume.

Enlarged prostate is also suggested by bulging of median lobe into the urinary bladder.
You also need PSA estimation.
Since you don't have any symptoms, it need clinical correlation.

You also need vitamin D supplementation.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (13 minutes later)

Transrectal ultrasonography (TRUS) has not been done yet.

Prostate specific antigen - Total(PSA) (Serum/Chemiluminescence) 1.59 ng/mL (Ref range 0 - 4.0) is available dated 22 Nov 2014.


Does the volume 42-43cc (using USG) of prostate indicate for immediate surgery or should it be done after receipt of any relevant symptom only?
doctor
Answered by Dr. Indu Kumar (6 hours later)
Brief Answer:
You may only need close follow up.

Detailed Answer:
Hello XXXXXXX

It is good that PSA level is within normal limit.

As you don't have any symptoms,you may only need close follow up.You may need yearly USG for assessing prostate size and echotexture.
I don't think you need immediate surgery.Even in symptomatic patients,enlarged prostate respond well to medicines.
Surgery in required in moderate to severe cases.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6728 Questions

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What Does The Following CT Scan Of Prostate Indicate?

Brief Answer: USG is more accurate especially TRUS. Detailed Answer: Hello XXXXXXX USG is ideal for estimating prostate volume.CT tends to overestimate prostate volume.However,both readings suggests enlarged prostate in your case. Transrectal ultrasonography(TRUS) is ideal for estimation of prostate volume. Enlarged prostate is also suggested by bulging of median lobe into the urinary bladder. You also need PSA estimation. Since you don't have any symptoms, it need clinical correlation. You also need vitamin D supplementation. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX