Imaging assessments of lower urinary tract dysfunctions: Future steps

Area of Science:

• Urology
• Medical Imaging
• Biomedical Engineering

Background:

• Urodynamic tests are standard for lower urinary tract dysfunction (LUTD) but are invasive.
• There is a need for noninvasive diagnostic methods for LUTD.
• Current noninvasive techniques are under development and standardization.

Purpose of the Study:

• To review noninvasive imaging techniques for monitoring LUTD.
• To discuss the application and limitations of these techniques.
• To highlight the potential for future clinical use.

Main Methods:

• Review of existing literature on noninvasive imaging for LUTD.
• Focus on 2D ultrasonography, Doppler ultrasonography, and near-infrared spectroscopy (NIRS).
• Analysis of static and dynamic imaging parameters.

Main Results:

• Ultrasonographic parameters (BWT, DWT, UEBW) show potential for diagnosing bladder outlet obstruction (BOO) and detrusor overactivity (DO).
• NIRS can detect real-time hemodynamic changes but is susceptible to motion artifacts.
• Real-time bladder strain imaging using 2D ultrasound allows noninvasive monitoring of bladder wall dynamics.

Conclusions:

• Noninvasive imaging techniques are emerging as viable alternatives to invasive urodynamics for LUTD diagnosis.
• Standardization of measurement methods and further development are needed for widespread clinical adoption.
• These techniques offer potential for real-time, dynamic assessment of bladder function during the micturition cycle.