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MP18-18: Three-dimensional vs. two-dimensional shear-wave elastography of the testes – preliminary study on a healthy collective

Friday, May 12
3:30 PM - 5:30 PM
Location: BCEC: Room 153

Presentation Authors: Julian Marcon*, Matthias Trottmann, Johannes Ruebenthaler, Melvin D'Anastasi, Christian G. Stief, Maximilian F. Reiser, Dirk Andre Clevert, Munich, Germany

Introduction: Shear wave elastography (SWE) is a newer technique for the determination of tissue elasticity. The measured velocity of generated shear waves (SWV) has been shown to correlate positively with tissue stiffness. SWE is integrated into many modern ultrasound systems and has been used in different organ systems. Two-dimensional SWE (2D SWE) of the testes has been found to be a useful tool in recent studies on healthy volunteers. Three-dimensional SWE (3D SWE) is the latest development and is made possible by generation of a multiplanar 3D map via volumetric acquisition using a special ultrasound transducer. This technique allows the assessment of tissue elasticity in a fully accessible 3D organ map.
The aim of this preliminary study was to both evaluate the feasibility of 3D SWE and to compare 2D and 3D SWE standard values in the testes of healthy subjects.


Methods: We examined the testes of healthy male volunteers (n=32) with a mean age of 51.06 ± 17.75 years (range 25-77 years) by B-mode ultrasound, 2D and 3D SWE techniques. Volunteers with a history of testicular pathologies were excluded. For all imaging procedures the SL15-4 linear transducer (bandwidth 4-15 MHz) as well as the SLV16-4 volumetric probe (bandwidth 4-16 MHz) of the Aixplorer® ultrasound device (SuperSonic Imagine, Aix-en-Provence, France) were used. Seven regions of interest (ROI, Q-Box®) within the testes were evaluated for SWV using both procedures. SWV values were described in m/s. Furthermore, we calculated testicular volume using both techniques and the formula for ellipsoid forms (LxWxHx0.523). Results were statistically evaluated using univariate analysis.

Results: Mean SWV values were 1.05 m/s for the 2D SWE and 1.12 m/s for the 3D SWE.
Comparisons of local areas delivered no statistically significant differences (p=0.11 to p=0.66), except for one ROI in the central portion of the coronal plane (p=0.03). Testicular volume was significanty higher by a mean of 1.72 ml when measured with 3D SWE (p=0.001).


Conclusions: In the assessment of testicular tissue 3D SWE proved to be a feasible diagnostic tool, while delivering similar values compared to the 2D method. It provided the examiner with a fully accessible three-dimensional map in a multiplanar view. Using 3D ultrasound a more precise testicular imaging, especially if combined with the display of tissue stiffness in SWE, is available and therefore could improve the diagnostic work-up of scrotal masses and male infertility. Further studies for a better understanding in the context of various testicular pathologies will be required.

Source Of Funding: none

Julian Marcon, Resident in urology

Department of Urology, LMU Munich

Julian Marcon
Resident physician in urology
Dept. of Urology, Ludwig-Maximilians-University of Munich, Munich, Germany

2007 - 2013: Medical studies, Ludwig-Maximilians-University of Munich
2014 - today: Residency in urology, Department of Urology, Ludwig-Maximilians-University of Munich, Germany
(Head of Department: Prof. Dr. Christian G. Stief)

Scientific focus: Imaging in urology, andrology, infectiology

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MP18-18: Three-dimensional vs. two-dimensional shear-wave elastography of the testes – preliminary study on a healthy collective



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