Comparison of conventional ultrasound and real-time spatial compound imaging in evaluation of patients with severe Peyronie's disease.
BACKGROUND
Real-time spatial compound imaging (C-US) is an ultrasound (US) method which effectively reduces image artifacts and noise. In contrast to conventional techniques, multiple frames are acquired from different viewing angles and combined to form a single compound image.


OBJECTIVE
To evaluate whether C-US improves ultrasound evaluation of patients with severe Peyronie's disease.


METHODS
60 consecutive patients with severe Peyronie's disease underwent conventional US and C-US after intracavernous prostaglandin E1 injection. Corresponding images of the same scan plane were obtained with both methods, and subjective image quality was scored retrospectively using a four-point scale by two blinded readers with different experience in penile imaging. Readers focused on evaluation of the tunica albuginea, plaques, involvement of the penile septum, and overall image quality. Also, presence of large albugineal calcifications or microcalcifications was considered. To assess intrareader agreement, both readers repeated evaluation after a 1-month interval. Statistical analysis was performed using the Wilcoxon signed-rank test and McNemar test. Weighted kappa values were calculated to assess intra- and inter-reader agreement.


RESULTS
Average scores were significantly higher for reader 1 (P<0.001). Both readers rated C-US better (P<0.001) than conventional US. Despite higher image quality scores, C-US was as effective as conventional grayscale US in assessing involvement of the penile septum. No differences were found between the two methods for visualization of large calcifications, while microcalcifications were better visible with compound imaging. Intrareader agreement was higher for the more experienced reader 1.


CONCLUSIONS
C-US is subjectively superior to conventional US in evaluating patients with severe Peyronie's disease.
Department of Radiology, University of Trieste, Trieste, Italy. bertolot@units.it
M
M
Bertolotto
R
R
Perrone
S
S
Bucci
R
R
Zappetti
M
M
Coss
D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D015588:Observer Variation; D010411:Penile Induration / Q000175:diagnosis*; D010413:Penis / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012815:Signal Processing, Computer-Assisted; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods