A Novel Method to Quantify Penile Arterial Blood Supply Using Shear Wave Elastography During Penile Duplex Ultrasound in Men with Erectile Dysfunction

BACKGROUND: Peak systolic volume (PSV), the essential parameter of penile Doppler ultrasonography (PDU), can reflect the penile artery blood supply. The present study was conducted to explore the correlations between PDU parameters and shear wave elastography (SWE), a feasible technology to measure penile stiffness. MATERIAL/METHODS: A total of 78 erectile dysfunction (ED) patients and 32 healthy controls were enrolled in our study. The PDU and SWE were performed to each participant simultaneously by a blinded radiologist. The penoscrotal junction was used to measure the PDU parameters and the SWE values. The PDU and SWE measurements were conducted formally at flaccid state and 5, 10, 15, 20, and 25 min after intra-cavernous injection (ICI) of vasoactive agents. RESULTS: The significant correlation between PSV and SWE value was found in both ED patients (r=−0.748, P<0.001) and healthy controls (r=−0.815, P<0.001). SWE values of corpus cavernosum penis (CCP) decreased significantly with the increase of PSV during penile erection in both the ED patients and healthy controls. When the SWE value of CCP was less than 11.57 kPa, it showed that the penile artery blood supply was sufficient to finish satisfactory sexual intercourse. The sensitivity and specificity were 0.838 and 0.872, respectively. CONCLUSIONS: Quantitative measurement of SWE values in CCP can reflect the penile arterial blood supply during PDU examination. The SWE technique could be used for evaluating the penile artery blood supply combined with the ICI test, with the advantages of noninvasiveness, simple operation, and excellent repeatability.