Super‐resolution ultrasound localization microscopy for the non‐invasive imaging of human testicular microcirculation and its differential diagnosis role in male infertility
Maoyao Li,
Lei Chen,
Jipeng Yan,
Channa Nalin Jayasena,
Zhangshun Liu,
Jia Li,
Ao Li,
Jiang Zhu,
Ronghui Wang,
Jianchun Li,
Chaoxue Zhang,
Jingyi Guo,
Yuwu Zhao,
Chao Feng,
Mengxing Tang,
Yuanyi Zheng
Affiliations
Maoyao Li
Department of Ultrasound Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
Lei Chen
Department of Ultrasound Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
Jipeng Yan
Department of Bioengineering Imperial College London London UK
Channa Nalin Jayasena
Department of Metabolism, Digestion and Reproduction Imperial College London London UK
Zhangshun Liu
Department of Reproductive Medicine Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
Jia Li
Department of Ultrasound Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
Ao Li
Department of Ultrasound The First Affiliated Hospital of Nanjing Medical UniversityNanjing China
Jiang Zhu
Department of Ultrasound Women's Hospital, Zhejiang University School of Medicine Hangzhou China
Ronghui Wang
Department of Ultrasound Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai China
Jianchun Li
Department of Ultrasound Medicine Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical CollegeHangzhou China
Chaoxue Zhang
Department of Ultrasound The First Affiliated Hospital of Anhui Medical University Hefei China
Jingyi Guo
Clinical Research Center Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
Yuwu Zhao
Department of Neurology Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
Chao Feng
Department of Reproductive Medicine The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai China
Mengxing Tang
Department of Bioengineering Imperial College London London UK
Yuanyi Zheng
Department of Ultrasound Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
Abstract Testicular microcirculation is closely related to spermatogenic function and seminiferous tubular function. The diagnosis and monitoring of testicular diseases can be associated with testicular microcirculation; however, there are currently no effective non‐invasive methods for super‐resolution imaging of testicular microcirculation. In this study, we introduced state‐of‐the‐art graph‐based tracking with the Kalman motion model algorithm to non‐invasively image human testicular microcirculation for the first time with a regular frame‐rate clinical ultrasound imaging system (37 Hz). Two distinct testicular vessels with an 81 µm separation were resolved in the testicular vasculature, surpassing all other imaging modalities. In a retrospective study, we performed contrast‐enhanced ultrasound examinations(CEUS) and ultrasound localization microscopy (ULM) processing on the included 76 infertile patients and 15 healthy controls from August 2021 to May 2023 and obtained super‐resolution images of testicular microcirculation with sub‐diffraction resolution. Through the results of one‐way analysis of variance tests and receiver operating characteristic analyses, we found that the ULM‐based parameters hold promise as clinical guidance for differentiating between non‐obstructive and obstructive male infertility. The mean vessel diameter achieved an area under the curve (AUC) of 0.920 (95% confidence interval [CI]: 0.847–0.994, p < .001) with a cut‐off value of 170.9 µm in oligoasthenospermia, and an AUC of 0.952 (95% CI: 0.875–1.000, p < .001) with a cut‐off value of 169.9 µm in azoospermia patients, respectively, addressing a significant clinical challenge.
