Quantitative Proton Spectroscopy of the Testes at 3 T

Storey, Pippa; Gonen, Oded; Rosenkrantz, Andrew B.; Khurana, Kiranpreet; Zhao, Tiejun; Bhatta, Rajesh; Alukal, Joseph P.

doi:10.1097/rli.0000000000000414

Cited by 18 publications

(13 citation statements)

References 19 publications

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“…The results of our study demonstrated low normalized concentrations of Cho in NOA men. Similar results were reported by previous studies 15–17 . Based on literature data, 11,12,14–17 Cho appears to be a useful noninvasive fingerprint of spermatogenesis.…”

Section: Discussionsupporting

confidence: 90%

“…Data on the usefulness of proton MRS in assessing the biochemical composition of human testes are still preliminary 5,11–19 . Pathologic alterations in metabolic peaks have been reported in testes with impaired spermatogenesis and testicular mass lesions 5,14–19 .…”

Section: Introductionmentioning

confidence: 99%

“…10 Data on the usefulness of proton MRS in assessing the biochemical composition of human testes are still preliminary. 5,[11][12][13][14][15][16][17][18][19] Pathologic alterations in metabolic peaks have been reported in testes with impaired spermatogenesis and testicular mass lesions. 5,[14][15][16][17][18][19] The initial results of proton MRS are promising in testes with NOA, proving valuable noninvasive fingerprints of the complex process of spermatogenesis.…”

Section: Introductionmentioning

confidence: 99%

“…5,[11][12][13][14][15][16][17][18][19] Pathologic alterations in metabolic peaks have been reported in testes with impaired spermatogenesis and testicular mass lesions. 5,[14][15][16][17][18][19] The initial results of proton MRS are promising in testes with NOA, proving valuable noninvasive fingerprints of the complex process of spermatogenesis. 20 Measuring Cho intensity in the testis spectroscopy of fertile males suggested that Cho could be used as a predictive spermatogenesis marker.…”

Section: Introductionmentioning

confidence: 99%

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Diffusion‐weighted magnetic resonance imaging and magnetic resonance spectroscopy for non‐invasive characterization of azoospermia: A prospective comparative single‐center study

et al. 2023

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Background Azoospermia affects about 15% of childless males. The differential diagnosis between subtypes of azoospermia is the initial step in its management. Objectives To investigate the role of diffusion‐weighted magnetic resonance imaging and proton magnetic resonance spectroscopy in distinguishing obstructive azoospermia from non‐obstructive azoospermia and predicting sperm retrieval together with histological alterations in men with non‐obstructive azoospermia. Materials and methods This prospective comparative study involved 60 men with obstructive azoospermia (group A) and 60 men with non‐obstructive azoospermia (group B). Scrotal proton magnetic resonance spectroscopy and diffusion‐weighted magnetic resonance imaging were conducted for all participants to respectively evaluate testicular metabolites and normalized apparent diffusion coefficient 1 week before sperm retrieval. Results Apparent diffusion coefficient was significantly higher in group B as compared to group A (0.47 ± 0.11 vs. 0.29 ± 0.05; and 0.46 ± 0.14 vs. 0.28 ± 0.02) for the right and left testis, respectively. Conversely, testicular choline and lipids were significantly higher in group A as compared to group B. Normalized apparent diffusion coefficient, choline, and lipids at cut‐off levels of 0.353, 0.31, and 0.725 could differentiate between obstructive azoospermia and non‐obstructive azoospermia (area under the curve = 0.963; confidence interval = 0.939–0.986, area under the curve = 0.985; confidence interval = 0.974–0.997, and area under the curve = 0.970; confidence interval = 0.940–0.999, respectively). Regarding the prediction of sperm retrieval in the non‐obstructive azoospermia group, choline levels had the highest area under the curve (0.923), and its cut‐off level was 0.195. The normalized apparent diffusion coefficient was significantly lower in men with positive sperm retrieval as compared to men with unsuccessful retrieval. Finally, it was revealed that all magnetic resonance imaging parameters except creatine could independently predict testicular histology in men with non‐obstructive azoospermia. The highest prediction was 95% in normal spermatogenesis, and the least prediction was 40% in spermatid arrest. Regression analysis was used to detect final predictors and extrapolate an equation that could be used to predict testicular pathology Conclusions Normalized apparent diffusion coefficient and proton magnetic resonance spectroscopy are helpful in differentiating obstructive azoospermia from non‐obstructive azoospermia and predicting sperm retrieval and related histological alterations in men with non‐obstructive azoospermia.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diffusion‐weighted magnetic resonance imaging and magnetic resonance spectroscopy for non‐invasive characterization of azoospermia: A prospective comparative single‐center study

et al. 2023

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“…Another study suggested that testicular metabolite concentrations measured by 3T proton spectroscopy can be used as non-invasive biomarkers to predict spermatogenesis. 71 A study showed that phosphocholine concentrations were significantly higher in normal testes compared with Sertoli cells only. 72 This finding indicated that the unique metabolic profile of spermatogenesis may be identified by proton magnetic resonance spectroscopy, which is helpful in non-invasive diagnosis of spermatozoa in men with NOA.…”

Section: Factors Predicting the Srr In Patients With Noa Before Surgerymentioning

confidence: 99%

Predictors of testicular sperm retrieval in patients with non-obstructive azoospermia: a review

et al. 2021

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Azoospermia is divided into two categories of obstructive azoospermia and non-obstructive azoospermia. Before 1995, couples with a male partner diagnosed with non-obstructive azoospermia had to choose sperm donation or adoption to have a child. Currently, testicular sperm aspiration or micro-dissection testicular sperm extraction combined with intracytoplasmic sperm injection allows patients with non-obstructive azoospermia to have biological offspring. The sperm retrieval rate is significantly higher in micro-dissection testicular sperm extraction compared with testicular sperm aspiration. Additionally, micro-dissection testicular sperm extraction has the advantages of minimal invasion, safety, limited disruption of testicular function, a low risk of postoperative intratesticular bleeding, and low serum testosterone concentrations. Failed micro-dissection testicular sperm extraction has significant emotional and financial implications on the involved couples. Testicular sperm aspiration and micro-dissection testicular sperm extraction have the possibility of failure. Therefore, predicting the sperm retrieval rate before surgery is important. This narrative review summarizes the existing data on testicular sperm aspiration and micro-dissection testicular sperm extraction to identify the possible factor(s) that can predict the presence of sperm to guide clinical practice. The predictors of surgical sperm retrieval in patients with non-obstructive azoospermia have been widely studied, but there is no consensus.

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Proton MR Spectroscopy in Assessing the Biochemical Milieu of Human Testes

Tsili

Astrakas

Sofikitis

et al. 2020

Magnetic Resonance Imaging

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Proton magnetic resonance spectroscopy (MRS), considered a connection between metabolism and anatomic and functional information provided by standard MRI, gives information on various tissue metabolites and their pathologic changes. Recently, proton MRS has been added as an adjunct tool to the multiparametric protocol of scrotal MRI, providing a new insight into the extremely complex biochemical milieu of normal and abnormal testes. This article reviews proton MR spectra of normal testes, showing age and bilateralism dependence. Disturbances of various metabolic pathways in testes of infertile men resulting in alterations of metabolite peaks are discussed. Preliminary data on proton MR spectra of testicular mass lesions are presented. Level of Evidence: 5. Technical Efficacy Stage: 5.

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Quantitative Proton Spectroscopy of the Testes at 3 T

Abstract: Testicular metabolite concentrations, measured by proton spectroscopy at 3 T, may be valuable as noninvasive biomarkers of spermatogenesis.

Cited by 18 publications

References 19 publications

Diffusion‐weighted magnetic resonance imaging and magnetic resonance spectroscopy for non‐invasive characterization of azoospermia: A prospective comparative single‐center study

Diffusion‐weighted magnetic resonance imaging and magnetic resonance spectroscopy for non‐invasive characterization of azoospermia: A prospective comparative single‐center study

Predictors of testicular sperm retrieval in patients with non-obstructive azoospermia: a review

Proton MR Spectroscopy in Assessing the Biochemical Milieu of Human Testes

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