Elastography and diffusion-weighted MRI in patients with testicular microlithiasis, normal testicular tissue, and testicular cancer: an observational study

Malene Roland Pedersen, Palle Jørn Sloth Osther, Henrik Dahl Nissen, Peter Vedsted, Henrik Møller, Søren Rafael Rafaelsen

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15 Citations (Scopus)

Abstract

BACKGROUND: Ultrasound elastography is increasingly available in clinical practice. Recent studies showed higher velocity stiffness in testicular tumors compared to normal testicles.

PURPOSE: To evaluate ultrasound elastography in combination with the apparent diffusion coefficient measurements in diffusion weighted (DW) magnetic resonance imaging (MRI) in testicles. DW can be a useful tool in evaluating testicular malignancies. However, the relationship between velocity stiffness and MRI diffusion is not well established.

MATERIAL AND METHODS: We prospectively included 132 patients with testicular microlithiasis (n = 53), or normal testicular tissue (n = 53), or suspected for testicular cancer (n = 26). All 132 patients underwent ultrasonography including shear wave elastography and MRI diffusion coefficient examination of the scrotum.

RESULTS: No clinically relevant difference in velocity stiffness was found between normal and testicles with microlithiasis. There was a significant difference in stiffness between patients with testicular microlithiasis (0.78 m/s), normal testicular tissue (0.77 m/s), and patients with testicular cancer (1.95 m/s) ( P ≤ 0.001). Similarly, there was a statistically significant difference in MRI diffusion values between patients with testicular microlithiasis (0.978 × 10-3 mm2 s-1), normal testicular tissue (0.929 × 10-3 mm2 s-1), and testicular cancers (0.743 × 10-3 mm2 s-1) ( P < 0.01).

CONCLUSION: Patients with testicular microlithiasis had no malignant characteristics measured with shear wave elastography or MRI diffusion. MRI diffusion and elastography may be useful to preoperatively differentiate benign from malignant testicular lesions.

Original languageEnglish
JournalActa Radiologica
Volume60
Issue number4
Pages (from-to)535-541
Number of pages7
ISSN0284-1851
DOIs
Publication statusPublished - Apr 2019
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Calculi/diagnostic imaging
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging/methods
  • Elasticity Imaging Techniques/methods
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Testicular Diseases/diagnostic imaging
  • Testicular Neoplasms/diagnostic imaging
  • Testis/diagnostic imaging
  • Young Adult

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