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Zhou M, Zhang L, Zeng J, Lan Y, He F, Gao W, Li J, Wang Q, Guo W, Yuan Z, Zhang J. Visualizing the early-stage testicular torsion by dual-modal photoacoustic and ultrasound imaging. PHOTOACOUSTICS 2023; 31:100523. [PMID: 37362871 PMCID: PMC10285283 DOI: 10.1016/j.pacs.2023.100523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/27/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023]
Abstract
Delayed treatment of testicular torsion (TT) can lead to permanent loss of reproductive capacity. Photoacoustic imaging (PAI) and ultrasound imaging (USI) was tested for detecting TT at early stage in mice based on PAI-obtained oxygen saturation (sO2), and USI-collected color pixel density (CPD), peak systolic velocity (PSV) and resistance index (RI). For complete TT, both CPD (9.08 % ± 3.084 to almost zero) and sO2 data (70.09 % ± 1.656-59.84 % ± 1.427) showed an significant change 2 h post-torsion. For incomplete TT, sO2 data exhibited a strong time relationship (Mean values: 6 h, 64.83 % ± 1.898; 12 h, 60.67 % ± 3.555; 24 h, 57.85 % ± 3.575; P < 0.05). However, USI-collected CPD, PSV or IR data from the same TT models showed no significant difference. This study indicated that USI and PAI could identify complete TT. Meanwhile, PAI has shown great potential in the diagnosis of incomplete TT within 24 h based on time-related sO2 map.
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Affiliation(s)
- Mengyu Zhou
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Engine Research Center of Urinary Continence and Reproductive Medicine, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, Guangdong, China
| | - Luting Zhang
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jianwen Zeng
- Guangdong Engine Research Center of Urinary Continence and Reproductive Medicine, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, Guangdong, China
| | - Yintao Lan
- Bioland Laboratory (Guangzhou Regenerative Medicine and Health—Guangdong Laboratory), Guangzhou, Guangdong, China
| | - Fengbing He
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weijian Gao
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jinghang Li
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qian Wang
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weisheng Guo
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhen Yuan
- Faculty of Health Sciences, University of Macao, Macao, China
| | - Jian Zhang
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Engine Research Center of Urinary Continence and Reproductive Medicine, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, Guangdong, China
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Ali Üncü Y, Şekerci ÇA, Yücel S, Sircan-Kucuksayan A, Çam HK, Savaş M, Yıldırım A, Ağras K, Baykara M, Canpolat M. Diagnosis of Testicular Torsion and Differentiation From Other Pathologies Using Near-Infrared Spectroscopy. Urology 2023; 173:159-163. [PMID: 36642118 DOI: 10.1016/j.urology.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To develop a near-infrared (NIR) spectroscopy device to diagnose testicular torsion with high sensitivity and specificity. Specifically, we aim to investigate the differentiation between testicular torsion from other pathologies such as orchidoepididymitis, varicocele, and hydrocele. METHODS Two LEDs with wavelengths of 660 nm and 940 nm were used as light sources in the device. Each wavelength was sent to the testicle successively, and a photodiode detected back-reflected diffuse light. The ratio of the light intensities of 660 nm and 940 nm was used as a diagnostic parameter. A multi-center clinical trial was performed in 5 different hospitals. RESULTS In total, 62 patients in urology clinics with acute testicular pain have been recruited for the study. The developed NIR spectroscopy correctly defined all 8 testicular torsion cases. Besides, 3 orchidoepididymitis, 1 varicocele, and 3 hydrocele cases were correctly distinguished from testicular torsion. Only 1 hydrocele case was misdiagnosed as torsion. The range of the ratio was between 0.14 and 1.16 overall measurements. The ratio varied between 0.14 and 0.3 for the testicle with torsion. The ratio was between 0.49 and 1.16 for the normal testicle and testicle with other pathologies mentioned above. CONCLUSION We have chosen the threshold ratio of 0.4 to differentiate between the normal and torsion testis and diagnosed all the torsion cases among all normal and other pathologies. The developed optical device to diagnose testicular torsion is inexpensive, user-friendly, and works based on objective criteria with high sensitivity and specificity in real time.
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Affiliation(s)
- Yiğit Ali Üncü
- Biomedical Optics Research Unit, Department of Biophysics, School of Medicine, Akdeniz University, Antalya, Turkey; Akdeniz University, Vocational School of Technical Sciences, Department of Biomedical Equipment Technology, Antalya, Turkey
| | - Çağrı Akın Şekerci
- Department of Urology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Selçuk Yücel
- Department of Urology, Acibadem Mehmet Ali Aydinlar University Atakent Hospital, Istanbul, Turkey; Department of Urology, Marmara University School of Medicine, Istanbul, Turkey
| | - Aslınur Sircan-Kucuksayan
- Biomedical Optics Research Unit, Department of Biophysics, School of Medicine, Akdeniz University, Antalya, Turkey; Department of Biophysics, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Haydar Kamil Çam
- Department of Urology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Murat Savaş
- Department of Urology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Asıf Yıldırım
- Department of Urology, İstanbul Medeniyet University School of Medicine, Ministry of Health İstanbul Göztepe Training and Research Hospital, Istanbul, Turkey; Department of Urology, İstanbul Medeniyet University School of Medicine, Ministry of Health İstanbul Göztepe Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Koray Ağras
- Urology Clinic, Ministry of Health Ankara Atatürk Training and Research Hospital, Ankara, Turkey; Private Medical Office, Ankara, Turkey
| | - Mehmet Baykara
- Department of Urology, Faculty of Medicine, Akdeniz University, Antalya, Turkey; Department of Urology, Lara Anadolu Hospital, Antalya Turkey
| | - Murat Canpolat
- Biomedical Optics Research Unit, Department of Biophysics, School of Medicine, Akdeniz University, Antalya, Turkey.
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Laher A, Ragavan S, Mehta P, Adam A. Testicular Torsion in the Emergency Room: A Review of Detection and Management Strategies. Open Access Emerg Med 2020; 12:237-246. [PMID: 33116959 PMCID: PMC7567548 DOI: 10.2147/oaem.s236767] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022] Open
Abstract
Testicular torsion is a challenging and time-sensitive diagnosis that is encountered frequently in daily practice, especially in the emergency room. A thorough history, the presence of a painful and swollen testis and testicular ultrasonography plays a vital role in the prompt diagnosis of testicular torsion. Prompt diagnosis is essential to prevent complications of testicular torsion which include testicular infarction, necrosis, and sub/infertility. This can be challenging as there are various other conditions that may mimic the presentation of testicular torsion. Since testicular torsion is an extremely time-sensitive diagnosis, it may also be a subject of many medicolegal challenges. This review article serves as a guide for clinicians involved with the diagnosis and management of testicular torsion. We review and discuss detection and management strategies based on their validity, statistical significance, and effectiveness in enabling prompt diagnosis and management of testicular torsion. Medicolegal implications of testicular torsion are also highlighted.
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Affiliation(s)
- Abdullah Laher
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shavania Ragavan
- Division of Urology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Puja Mehta
- Division of Urology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ahmed Adam
- Division of Urology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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