Yu Luyang, Lue Yanhe, Yang Hang, Liu Junze, Vega Carlos, Ho Kevin, Rajfer Jacob, Wang Christina, Swerdloff Ronald, Hyle Park B
University of California Riverside, Department of Bioengineering, Riverside, California, United States.
The Lundquist Institute at Harbor-UCLA Medical Center, Division of Endocrinology, Department of Medicine, Torrance, California, United States.
J Biomed Opt. 2025 Apr;30(4):046005. doi: 10.1117/1.JBO.30.4.046005. Epub 2025 Apr 8.
The ability to detect and localize sperm in the testes is crucial for the treatment of non-obstructive azoospermia (NOA), a condition where sperm retrieval is challenging due to the lack of visible sperm. Enhancing the accuracy and efficiency of sperm detection can significantly improve the outcomes of microdissection testicular sperm extraction (micro-TESE) procedures in NOA patients.
We aim to use optical coherence tomography (OCT) to detect the presence or absence of sperm in the imaged areas of the testes and to localize sperm-containing seminiferous tubules in a rat model of NOA.
Volumetric OCT scanning was performed on 180 distinct regions from the testes of two control and 15 busulfan-treated rats to mimic NOA. Following scanning, excised tubules were observed under a dissecting microscope with transillumination to confirm the presence of sperm. The OCT data were processed by first delineating the tubule lumen and then evaluating the calibrated intensity and attenuation coefficient within the lumen. These quantifications, along with outer tubule diameter, were evaluated to identify sperm by comparison with the results of the microscope examination.
Our OCT results revealed a significant correlation between the presence of sperm and high attenuation coefficients in a rat model of NOA. The accuracy of sperm detection by OCT is 97.8% when compared with microscopic identification. In addition, OCT data were utilized for color-coded processing to automatically distinguish regions with a greater likelihood of the presence of sperm, which may assist surgeons in locating occult sperm in NOA patients.
By providing high-resolution, non-invasive, automatic capture, and color-coded images, OCT has the potential to significantly enhance the efficiency of identification of tubules with spermatozoa during micro-TESE.
在睾丸中检测和定位精子的能力对于非梗阻性无精子症（NOA）的治疗至关重要，NOA是一种由于缺乏可见精子而导致精子获取具有挑战性的病症。提高精子检测的准确性和效率可显著改善NOA患者显微外科睾丸精子提取（micro-TESE）手术的效果。
我们旨在使用光学相干断层扫描（OCT）检测睾丸成像区域中精子的有无，并在NOA大鼠模型中定位含有精子的生精小管。
对两只对照大鼠和15只经白消安处理以模拟NOA的大鼠的睾丸中的180个不同区域进行容积OCT扫描。扫描后，在解剖显微镜下通过透照观察切除的小管以确认精子的存在。OCT数据的处理方法是先勾勒出小管腔，然后评估管腔内的校准强度和衰减系数。通过与显微镜检查结果进行比较，对这些量化指标以及小管外径进行评估以识别精子。
我们的OCT结果显示在NOA大鼠模型中精子的存在与高衰减系数之间存在显著相关性。与显微镜鉴定相比，OCT检测精子的准确率为97.8%。此外，OCT数据用于颜色编码处理，以自动区分更有可能存在精子的区域，这可能有助于外科医生在NOA患者中定位隐匿精子。
通过提供高分辨率、非侵入性、自动捕获和颜色编码图像，OCT有潜力显著提高micro-TESE期间识别含有精子的小管的效率。
