Testicular Imaging Technology
Optical Coherence Tomography:
A novel imaging modality for Testicular tissue
Wayne Kuang, M.D., Cole Davis M.D., Lynn Schoenfield, M.D. and Anthony J. Thomas Jr., M.D.
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Introduction: Optical Coherence Tomography (OCT) is a novel real-time imaging modality that uses near infrared light to visualize the microstructure of biotissues. OCT images can be obtained at a resolution that is 10-100x higher than ultrasound. At high level of resolution, cross-sectional images may closely reflect underlying histopathologic diagnoses. This study aims to determine whether OCT technology (Niris™ Imaging System, Cleveland, OH) can accurately reflect normal testicular histology. Such technology may prove to be a helpful intraoperative adjunct to improve sperm retrieval rates for men undergoing Testicular Sperm Extraction (TESE) for non-obstructive azoospermia.
Materials and methods: 86 OCT images were obtained from four infertile men who underwent testicular biopsy during the evaluation for suspected obstructive azoospermia. Images were acquired without any tissue distortion by placing the biopsy specimens on the tip of an 8 Fr imaging probe. The specimens were then sent to pathology in Hollande’s solution for permanent sections for parallel histology.
Results: Final pathology for all four men demonstrated normal spermatogenesis. A comparison between OCT images and final pathology suggests that OCT can approach a level of resolution that correlates with parallel histology in testicular biopsies.
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| The marked tubule size is 233 µm | Marked tubule size is 249 µm |
Conclusion: This preliminary study suggests that OCT technology has a level of resolution that approaches that of underlying normal testiclular histology. Further research will be needed to determine whether OCT can be clinically used to help identify areas of spermatogenesis in men undergoing TESE for non-obstructive azoospermia.