(156) Morphometrix Tissue Segmentation Technology as a Diagnostic Aid in the Evaluation of Vasculogenic Causes of Erectile Dysfunction

Abstract

Abstract Introduction Morphometrix Imaging Technologies Inc. (MPX) Tissue Segmentation Technology (TST) isolates and processes the component of ultrasound reflective signals associated with coherent specular reflection at the liquid spaces in living tissue. The software identifies and quantifies the hypoechoic structures in B-Mode Ultrasound Scans produced by these reflections and thereby profiles liquid spaces in the tissue created by blood and lymphatic vessels as a proxy for vascular intensity. It then derives tissue segment counts (TSC) as a final quantification step. Unlike SHIM Scores, TST provides a quantitative assessment of the vascular health of the erectile tissue. Objective The goal of the study was to determine whether TSC can predict a response to regenerative treatments for ED. We retrospectively studied the efficacy of MPX TST in assessing the vascularity of the corpus cavernosa (CC) and compared the findings to SHIM scores before and after Shockwave therapy (SWT). MPX can assess penile vascularity in the flaccid state using TSC and can calculate cross-sectional area and volume. Methods Retrospective study of 57 men, average age 54.9 with ED. B-mode Ultrasound video scans were performed on the penis in the flaccid state before and after treatment completion and processed through MPX to obtain the TSC which were compared to IIEF-5 SHIM scores. A typical treatment involved multiple sessions of SWT and PRP penile injection. Subjects were divided into three groups based on response to treatment and correlation with SHIM Scores: Group 1 – Good Responders & Good Correlation with SHIMs, Group 2 – Poor & Non-Responders & Good Correlation with SHIMs, Group 3 – Good & Poor Responders & Non-Correlation with SHIMs. Results Overall we had an 80.7% correlation between TSC and the SHIM Score results. The average SHIM score increased to 15.9 from 10.6, (p<0.006). The average TSC in the left CC increased to 25 from 17.3, (p<0.002). The average TSC in the right CC increased to 24.7 from 17.9, (p<0.002). 54.9% (34 patients) were good responders and the SHIM scores correlated well with TSC. The average SHIM score increased to 17.5 from 10.8, (p<0.001). The average TSC in the left CC increased to 28.1 from 15.3, (p<0.001). The average TSC in the right CC increased to 31.2 from 17.1, (p<0.003). 21.1% (12 patients) were poor responders and the SHIM scores correlated well with TSC. The average SHIM score increased 10.3 from 9.4, (p<0.554). The average TSC in the left CC declined to 13.5 from 15.5, (p<0.559). The average TSC in the right CC declined slightly to 14.9 from 12.5, (p<0.268). 19.3% (11 patients) were a mixture of good and poor responders and the SHIM scores did not correlate well with TSC. The average SHIM score increased to 15.1 from 11.3, (p<0.103). The average TSC in the left CC declined to 25.5 from 26.8, (p<0.919). The average TSC in the right CC declined to 25.5 from 25.7, (p<0.975). Conclusions MPX tissue segmentation software can provide quantitative information about the vascularity of the corpus cavernosa and can differentiate responders to treatment from non-responders. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Morphometrix.