2076630 An Enhanced Ultrasound Technique For Functional Evaluation Of Spermatogenesis

The only quantitative method used today to assess testicular function is Johnsen scoring of testicular histopathology. We propose that the heterogeneity found in testicular ultrasound images correlates with testicular function. To evaluate this heterogeneity we employ a noninvasive process that uses a dithering technique in which the pixels of an ultrasound image are transformed into a binary map. We then apply an algorithm to this binary map to determine Dynamic Range (DR) values. These DR quantities are used to assess levels of heterogeneity in gray scale ultrasound images. The purpose of this paper is to evaluate the correlation of DR with testicular histopathology. A retrospective review of all men who underwent testicular biopsy at our institution as part of a fertility evaluation was performed. All patients had ultrasound images taken preoperatively. The average DR for a single testis was obtained by performing the dithering method on five different ultrasound images and then averaged. The histologic specimens were reviewed by a single pathologist using a modified Johnsen criteria (0 to 10, >7 normal and ≤7 impaired spermatogenesis) to assess for the degree of impaired spermatogenesis. Pearson correlation, linear regression and Student’s t-test were obtained. Testicular biopsies were performed on a total of 32 patients. Complete data was available for 55 testes. A statistically significant negative correlation was found between DR and Johnsen scores (R2=0.29, Pearson r=-0.52, p<0.01). Johnsen scores ≤7 are associated with a mean DR=3.51. Whereas Johnsen scores ≥8 were associated with a mean DR=2.51. Intratesticular DR correlates with impaired spermatogenesis on testis biopsy. Evaluation of testicular ultrasound images through use of a dithering technique provides functional information. Potential exists for this non-invasive technique for real time assessment of testicular function.