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Biomedical Imaging and Instrumentation

Biomedical Imaging and Instrumentation - Poster Session E

Poster F10 - Ultrasound Bladder Shape Analysis During Urodynamics: Correlation of Bladder Circularity with Detrusor Overactivity

Saturday, October 26, 2024
10:00 AM - 11:00 AM EST
Location: Exhibit Hall E, F & G

Introduction:  Overactive Bladder (OAB) is a common condition characterized by urgency to void, and is often associated with increased voiding frequency and/or urge incontinence. Some individuals with OAB have involuntary bladder contractions during bladder filling, which are referred to as Detrusor Overactivity (DO). Presently, diagnosing DO relies on invasive urodynamics studies, which involve catheterization of the urethra and vagina or rectum to measure pressure increases during involuntary bladder contractions. This invasive procedure often causes discomfort, leading many individuals to delay seeking medical help until symptoms become severe. A previous study by Gray et al. (Ultrasound, 2019) showed a difference in bladder transverse ultrasound image sphericity in individuals with DO (DO+) compared to individuals without DO (DO-). This study explores a novel approach to diagnosing DO by analyzing changes in bladder circularity using abdominal ultrasound imaging during urodynamics studies. More specifically, this study tested the hypotheses that 1) bladder shape in the transverse plane in DO+ individuals become more circular at points of involuntary bladder contractions, and 2) bladder circularity during filling in DO+ individuals is greater than in DO- individuals. Developing a non-invasive diagnostic method for DO may improve patient comfort and encourage more timely medical intervention.

Materials and

Methods:  Women indicated for urodynamics were recruited for this prospective study. Transverse abdominal ultrasound images were obtained via screen capture during urodynamics. DO was identified based on analysis of intravesical and abdominal pressures during urodynamic filling. For DO+ participants, images were selected before, during, and after an involuntary contraction. For DO- participants, images were selected at points throughout bladder filling. The bladder walls in these images were traced, and circularity was quantified using the circularity function in ImageJ (Figure 1). Circularity values were analyzed to test the hypotheses that 1) increased bladder circularity during contractions correlates with DO+ and 2) that DO- individuals have smaller circularity values compared to DO+ individuals. Infused bladder volumes corresponding to the analyzed images and participant age and body mass index (BMI) were recorded.

Results, Conclusions, and Discussions: Data from nine DO+ and nine DO- women were analyzed. For the DO+ group, no increase in circularity at the peak of an involuntary bladder contraction (0.88±0.01) was identified compared to the circularity before (0.89±0.02) and after (0.88±0.02) the contraction (p>0.05). The average bladder circularity for the DO+ group (0.88±0.01) was significantly greater than for to the DO- group (0.83±0.02, p< 0.05) Bladder volumes for the images during the involuntary contractions in the DO+ group (321±53 ml) were not significantly different from the volumes associated with the last image analyzed for each of the DO- participants (271±40 ml). Demographic analysis revealed no significant differences between the DO+ and DO- groups in terms of age (68±5 vs 61±5 years, respectively, p>0.05) and BMI (29.5±1.5 vs 27.1±1.4). The results of this study indicate that bladders in DO+ individuals have greater circularity than those in DO- individuals, suggesting that they have more tone during filling and that non-invasive bladder ultrasound imaging may have potential as a method to screen for or diagnose DO. Future research studies with increased sample sizes and a control group of participants without any conditions affecting the bladder are needed to gain a deeper understanding of the relationship between bladder circularity and DO and determine whether specific bladder shape parameters can be used to clinically identify individuals with DO.

Acknowledgements (Optional):  This project was supported in part by the following awards: NIH R01DK101719, NSF REU 1852116, and the Virginia Commonwealth University School of Medicine Summer Research Fellowship Program.

Disclosure: Drs. Klausner & Speich have ownership interest in Vesi Corporation, a startup company that may benefit from the results of this study.