V4-10: “URODYNAMIC 4D-CT” Evaluation is a Highly Effective Technique for the Assessment of Urinary Conditions.
Male patients with LUTS have been examined using methods such as UFM, CMG, PFS and VCUG. Although PFS is thought to be specifically effective for assessing the degree of bladder outlet obstruction (BOO), it requires some skill to perform and is invasive to the patient. In addition, it is difficult to evaluate urinary disorders comprehensively in a single examination. Area Detector CT was applied to urodynamic study in a technique we call “Urodynamic 4D-CT”. We have already demonstrated the clinical effectiveness and convenience of “Urodynamic 4D-CT” imaging in the assessment of urinary conditions. In this clinical study, we examined urinary evaluations that combined Urodynamic 4D-CT with PFS.
A Toshiba Aquilion ONE 320 CT scanner (running on ZIO STATION 2) was used for scanning dynamic urinary flow images. After normal intravenous administration of a contrast agent as per regular CT scanning, 4D-CT images were taken during urination with the patient maintaining a half-seated position on the CT table. While shooting the X-rays, testis were protected from radiation exposure with a lead plate.
Using “Urodynamic 4D-CT”, 94 cases with LUTS were assessed to determine details regarding BPH, BNC and urethral stricture. The Bladder / prostate angle and the widest point in the prostatic urethra and bladder neck were demonstrated to be significantly improved after effective Holmium Laser prostatectomy (HoLEP). Movement of the upper bladder had been limited before performing the HoLEP operation, however, it is clear to see how bladder function improved dramatically once supported by the pubo-prostatic ligament post-operation. Urodynamic 4D-CT was shown to be effective at evaluating BOO status before treatment and predicting the outcomes of HoLEP for patients with BPH. Compared to the use of previous techniques, urination disorders were far easier to diagnose and understand when synchronizing PFS with Urodynamic 4D-CT.
Urodynamic 4D-CT was demonstrated to be a safe, thorough and revolutionary new method for assessment of urinary condition in a single examination. Urodynamic 4D-CT was able to illustrate the dynamic shape transition realized on the entire urinary tract chronologically, simply, and less invasively than other techniques. When used in conjunction with PFS, the possibility was clearly demonstrated for 4D-CT scanning to help accurately evaluate urinary conditions, as well as assess patient operability, with an efficiency superior to previous techniques.