Optimizing Anterior Urethral Stricture Assessment: Leveraging AI-Assisted Three-Dimensional Sonourethrography in Clinical Practice

Abstract Purpose This investigation sought to validate the clinical precision and practical applicability of AI-enhanced three-dimensional sonographic imaging for the identification of anterior urethral stricture. Methods The study enrolled 63 male patients with diagnosed anterior urethral strictures alongside 10 healthy volunteers to serve as controls. The imaging protocol utilized a high-frequency 3D ultrasound system combined with a linear stepper motor, which enabled precise and rapid image acquisition. For image analysis, an advanced AI-based segmentation process using a modified U-net algorithm was implemented to perform real-time, high-resolution segmentation and three-dimensional reconstruction of the urethra. A comparative analysis was performed against the surgically measured stricture lengths. Spearman’s correlation analysis was executed to assess the findings. Results The AI model completed the entire processing sequence, encompassing recognition, segmentation, and reconstruction, within approximately 5 minutes. The mean intraoperative length of urethral stricture was determined to be 14.452 ± 8.385 mm. Notably, the mean lengths of the urethral strictures reconstructed by manual and AI models were 13.092 ± 7.463 mm and 13.419 ± 7.216 mm, respectively. Interestingly, no statistically significant disparity in urethral stricture length between manually reconstructed and AI-reconstructed images was observed. Spearman’s correlation analysis underscored a more robust association of AI-reconstructed images with intraoperative urethral stricture length than manually reconstructed 3D images (0.869811 vs. 0.8201756). Furthermore, AI-reconstructed images provided detailed views of the corpus spongiosum fibrosis from multiple perspectives. Conclusions The research heralds the inception of an innovative, efficient AI-driven sonographic approach for three-dimensional visualization of urethral strictures, substantiating its viability and superiority in clinical application