AJR: MRI a desirable alternative to sonogram for diagnosis of testicular disease

Non-invasive MR Imaging is highly accurate in the preoperative characterization and local staging of testicular neoplasms and is a useful diagnostic tool for the evaluation of testicular disease, according to a study published in the March issue of the American Journal of Roentgenology.

Lead author Athina C. Tsili, MD, and colleagues from the department of clinical radiology at the University Hospital of Ioannina in Ioannina, Greece, sought to determine if MRI could play a role in the preoperative characterization and local staging of testicular masses.   

“Medical imaging plays an important role in the investigation of testicular masses,” said Tsili. “Sonography, although the primary imaging technique for the evaluation of scrotal contents, does not always allow confident characterization of the nature of a testicular mass.”

The researchers selected 33 patients (ranging in age from 17–70 years, with a mean age of 35 years) for their study who had been referred because a testicular mass had been detected by way of clinical examination and sonogram.  Each patient was administered gadolinium chelate and underwent imaging by a 1.5-T MRI unit.

Twenty-eight malignant (78 percent) and eight benign (22 percent) lesions where revealed in the 33 patients by histologic examination. Of the 36 lesions, the MRI correctly identified all 28 malignant lesions and 7 out of 8 of the benign lesions, wrote the authors.

As a result, the rate of correspondence between MRI and histologic diagnosis in the local staging of testicular tumors was 92.8 percent.  The researchers also noted a sensitivity rate of 100 percent and specificity finding of 87.5 percent.

The researchers wrote that this diagnosis method has the ability to improve patient care and possibly decrease the number of unnecessary surgical procedures, noting its advantages over sonography.  The advantages included acquisition of precise anatomic information, satisfactory tissue contrast and imaging in various planes.

However, the authors state that while MRI should be considered as an imaging technique, it should not be the first technique utilized for the investigation of testicular masses.

“MRI is an efficient diagnostic tool for the evaluation of testicular masses,” concluded Tsili.  “It is accurate in the preoperative differentiation of benign and malignant masses, facilitating accurate estimation of the local extent of disease in patients with malignant tumors.”

 

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