Prostate Assessment in clinic and online ordering

1.Planning scan

• Ensure prostate is not compressed, with posterior pressure of probe towards sacrum.
• Assess for significant middle lobe.
• Measure maximum height and width in transverse plane (A), length (B) and 2 para sagittal distances (C) in longitudinal plane parallel to the probe.

Five measurements may be obtained from T2 MRI images of the prostate. However, ensure the transverse view has been obtained perpendicular to the longitudinal view, otherwise, the height and possibly width may be overestimated. Care must also be taken to correctly identify the apex of the gland in the MRI view. The best correlation between U/S and MRI measurements is seen with glands less than 40cc. In patients where the MRI measurements are used to generate the seed order, it is recommended that a check U/S be performed prior to the implant procedure to verify the seed requirement.