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Diagnosing bladder outlet obstruction using non-invasive decorrelation based ultrasound imaging: A feasibility study in healthy male volunteers

Interview with Prof. Muhammad Arif

Hypothesis / aims of study

With increasing age men often develop Lower Urinary Tract Symptoms (LUTS), such as post-void residual volume, low urinary flow rate, nocturia and dribbling. These LUTS have a significant negative impact on the patient’s quality of life. Benign Prostate Enlargement (BPE), can result in compression of the urethra and may obstruct the bladder outlet BOO. A pressure-flow study that measures detrusor pressure and flow rate during voiding is currently the standard method for diagnosing BOO. A disadvantage of this method is that it involves urethral catheterization, which cause partial obstruction during micturition and may alter the diagnostic results. Therefore, the development of a non-invasive but accurate urodynamic method of diagnosing BOO is needed.

To develop such a clinical urodynamic method, we quantified flow velocity and turbulence in urethra models based on decorrelation of UltraSound (US) images during voiding. This technique estimates the decrease in correlation (or decorrelation) between sequentially acquired US RadioFrequency (RF) signals that are reflected by small scattering particles in the urine. Earlier studies have shown that the decorrelation depends on the urine flow velocity. In case of turbulence as a result of the obstruction, the decorrelation increased with the degree of obstruction. Therefore, US decorrelation might be used to non-invasively differentiate between healthy men and patients with LUTS as a result of BOO. In the present study, we investigated the in-vivo applicability of this method in healthy male volunteers.

Arif M1, Idzenga T1, L. de Korte C2, van Mastrigt R1

1. Erasmus MC, 2.Radboud University