Application of real-time shear wave elastography in the assessment of male infertility

Cui, Jun Shu; Du, Qiang; Fu, Wei

doi:10.21037/qims-21-648

Cited by 5 publications

(9 citation statements)

References 35 publications

(33 reference statements)

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“…This condition has been linked to fibrotic thickening of the walls of seminiferous tubules in the testicles. [24] It was also observed in another study by Erdogan et al that infertile men exhibited significantly higher testicular SWE values than healthy controls. They also stated that testicular stiffness increased with decreasing testicular volumes.…”

Section: Discussionmentioning

confidence: 64%

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The Evaluation of Testes by Shear Wave Elastography in Patients with Isolated Hypogonadotropic Hypogonadism

DERE,

KARAASLAN

2023

Journal of Contemporary Medicine

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Aim: The aim of this study was to evaluate testicular stiffness by shear wave elastography (SWE) in patients with isolated hypogonadotropic hypogonadism (IHH) and to compare it with healthy controls. Methods: In this prospective study, 35 patients with IHH (group 1) and 40 healthy controls (group 2) were evaluated. These two groups were compared in terms of age, testicular volume, and SWE values. In a subsequent analysis, IHH patients were divided into 3 groups: those who were newly diagnosed and did not receive any treatment (group A), those who received testosterone replacement (group B), and those who received human chorionic gonadotrophin alpha (hCG) (group C). Testicular volumes and SWE values were also compared between these subgroups. Results: Testicular volumes were significantly lower in group 1 than in group 2 (p

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Section: Discussionmentioning

confidence: 64%

“…[20,21] A number of studies have demonstrated that infertile males have increased testicular stiffness. [23][24][25][26] Urologists use tissue palpation to assess scrotal stiffness, but it is a subjective tool that requires experience. An abnormal spermiogram may indicate parenchymal damage.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of Testes by Shear Wave Elastography in Patients with Isolated Hypogonadotropic Hypogonadism

DERE,

KARAASLAN

2023

Journal of Contemporary Medicine

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“…The resulting increased stiffness can be detected by SWE, which evaluates the degree of testicular fibrosis and parenchymal damage ( 20 ). Many studies have shown that severe oligozoospermia and NOA are associated with increased testicular SWE-assessed stiffness ( 9 , 10 ). In our study, we more deeply examined the relationship between SWE and NOA, discovering that testicular stiffness increased as JS decreased, suggesting a strong correlation between stiffness and the parenchymal damage associated with spermatogenic function.…”

Section: Discussionmentioning

confidence: 99%

“…Testicular volume is a valuable clinical tool for evaluating the severity of male infertility ( 9 ), as it has a high predictive value for spermatogenesis, especially in patients with NOA ( 21 ). However, testicular volumes in these patients are typically smaller except in cases of early or late maturation arrest, which aligns with our study’s findings ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Shear wave elastography (SWE) is a widely used noninvasive method for assessing tissue stiffness and is an effective complement to conventional ultrasonography. Testicular elastic modulus, which is associated with sperm concentration, has been found to have a high diagnostic value for evaluating severe spermatogenic dysfunction ( 9 , 10 ). However, there have been few reports on the relationship between testicular stiffness and pathological findings in patients with NOA.…”

Section: Introductionmentioning

confidence: 99%

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The relationship of testicular stiffness with Johnsen score and sperm retrieval outcome in men with non-obstructive azoospermia

Fu,

Cui,

Tang

2024

Quant Imaging Med Surg

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Background The pathological Johnsen score (JS) is a quantitative histological scoring system used to assess spermatogenesis in men with nonobstructive azoospermia (NOA), while elastic modulus derived from shear wave elastography (SWE) is a diagnostic tool for evaluating spermatogenic dysfunction. In this prospective observational study, we aimed to investigate whether testicular stiffness measured by SWE could serve as a substitute for JS in predicting sperm retrieval outcomes in men with NOA. Methods This prospective cohort study analyzed 140 testes from 115 consecutive outpatient participants with NOA who had sought treatment at the reproductive medical center of a tertiary care hospital between January 2018 and October 2021. Testicular volume, elastic modulus, JS, and sperm retrieval outcomes were calculated. Statistical differences in parameters between the positive and negative sperm retrieval groups were determined using the Mann-Whitney test. Spearman rank correlation analysis was performed to determine the correlations between JS and either testicular volumes or elastic modulus. Receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic performance of the testicular elastic modulus and testicular volume. Results The JS correlated positively with testicular volume and negatively with the maximum elastic modulus (Emax) and mean elastic modulus (Emean), with correlation coefficients of 0.804, −0.686, and −0.456, respectively (P<0.01). There were significant differences in JS, testicular volume, and Emax between participants with positive and negative sperm retrieval of microdissection testicular sperm extraction (micro-TESE) (P<0.01). ROC curves were plotted for JS, testicular volume, and Emax to distinguish between participants with positive and negative sperm retrieval. The areas under the ROC curves (AUCs) were 0.783 [95% confidence interval (CI): 0.707–0.859; P<0.01], 0.737 (95% CI: 0.651–0.823; P<0.01), and 0.729 (95% CI: 0.643–0.814; P<0.01), respectively. When the cutoff value of JS was 4.5, its sensitivity and specificity were 60.3% and 89.6%, respectively. When the cutoff value of Emax was 3.75 kPa, its sensitivity and specificity were 79.1% and 64.4%, respectively. The sensitivity and specificity were 68.5% and 83.6%, respectively when the cutoff value of testicular volume was 8.17 mL. Emax combined with testicular volume improved this diagnostic value, with an AUC of 0.742 (95% CI: 0.657–0.828; P<0.01), and sensitivity and specificity were 83.6% and 68.5%, respectively. Conclusions Our study suggests that the combination of testicular stiffness and volume measurements may serve as a viable alternative to pathological JS in predicting the likelihood of successful sperm retrieval prior to micro-TESE procedures.

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Comparison of Testicular Sonography and Elastography Findings With Semen Parameters in Cases Investigated for Infertility

Aliyev,

Hekimsoy,

Tamsel

et al. 2024

J of Ultrasound Medicine

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ObjectivesThis study aimed to investigate the correlation between testicular shear wave elastography (SWE) values and semen analysis results in men with infertility.MethodsThis was a retrospective case–control study. Patients were categorized as normal, abnormal, or azoospermic based on sperm analysis results. Testicular volume was measured using B‐mode ultrasonography using the Lambert formula. Subsequently, 40–80 regions of interest measuring 1.5 × 1.5 mm were manually positioned in both testicles based on their size, and two‐dimensional SWE was applied through virtual touch imaging quantification software.ResultsThe patients had a mean age of 33.79 ± 6.3 years, with semen analysis revealing normal results in 15 patients (22.4%), pathological findings in 35 patients (52.2%), and azoospermia in 17 patients (25.4%). Right, left, total, and mean testicular volumes were significantly lower in patients with azoospermia compared to those in both normal and impaired semen parameters (P < .05). Conversely, testicular elastography scores were higher in patients with azoospermia than in the other groups (P < .05). The significant negative correlation between volume and elastographic findings remained independent of age (r = 0.4, P < .001). The accuracy rates for detecting impaired semen parameters and azoospermia were 94.3% and 94.1%, respectively, after considering factors such as age, testicular volume (right/left/total), and elastography (right/left/total). Notably, the total mean elastography score ranked first, with 100% in the independent normalized importance distribution of these variables.ConclusionSWE can be used effectively alone or in combination with other diagnostic tools to evaluate histopathological changes in the testicles of male patients with infertility.

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Application of real-time shear wave elastography in the assessment of male infertility

Cited by 5 publications

References 35 publications

The Evaluation of Testes by Shear Wave Elastography in Patients with Isolated Hypogonadotropic Hypogonadism

The Evaluation of Testes by Shear Wave Elastography in Patients with Isolated Hypogonadotropic Hypogonadism

The relationship of testicular stiffness with Johnsen score and sperm retrieval outcome in men with non-obstructive azoospermia

Comparison of Testicular Sonography and Elastography Findings With Semen Parameters in Cases Investigated for Infertility

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