Introduction: Patients with testicular cancer (TC) are mainly young and survival rates are high. MRI has several times been proposed to replace CT in follow-up of this patient group to reduce imagerelated radiation exposure. However, current evidence is scarce for the use of MRI in this context. Aims: First, to retrospectively evaluate the ability of MRI of the retroperitoneum and pelvis to detect relapse in patients with TC stage I. Second, to present a relevant MRI protocol of the retroperitoneum and pelvis with diffusion weighted imaging (DWI). Material and methods: A retrospective analysis of written radiology reports compared to clinical data from clinical practice from 2010 to 2018. The cohort consists of 2487 MRIs of the retroperitoneum and pelvis in 759 patients with TC stage I (524 seminoma (69.0%), 235 non-seminoma (31.0%)), including 102 patients (13.4%) with confirmed relapse. Confirmed relapse was defined when treatment was initiated for metastatic TC. Results: Ninety-five patients had a relapse in the MRI scan field during follow-up. MRI of the retroperitoneum and pelvis showed a high sensitivity of 93.8% and a high specificity of 97.4% for detecting TC relapse. The sensitivity for detecting relapse !10 mm in short axis lymph node diameter was 100%. The negative predictive value was 99.7%, the positive predictive value was 59.9% and the accuracy was 97.3%. Conclusions: MRI of the retroperitoneum and pelvis constitutes a safe alternative to CT in follow-up of patients with TC stage I with both a high sensitivity and a high specificity. We present a robust MRI protocol with DWI and estimate that MRI follow-up of TC stage I can be easily implemented in most modern radiology departments. Registration: Conducted with permission from the Danish Data Protection Agency (1-16-02-323-16) and the Danish Health Authority.

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Purpose Concerns of imaging-related radiation in young patients with high survival rates have increased the use of magnetic resonance imaging (MRI) in testicular cancer (TC) stage I. However, computed tomography (CT) is still preferred for metastatic TC.The purpose of this study was to compare whole-body MRI incl. diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) with contrast-enhanced, thoracoabdominal CT in metastatic TC.Methods A prospective, non-inferiority study of 84 consecutive patients (median age 33 years) with newly diagnosed metastatic TC (February 2018 -January 2021). Exclusion criteria were age <18 years, claustrophobia and MRI contraindications. Patients had both MRI and CT before and after treatment. Anonymised images were reviewed by experienced radiologists.Lesion malignancy was evaluated on a Likert scale (1 benign -4 malignant). Sensitivity, speci city, positive predictive value, negative predictive value and accuracy were calculated on patient and lesion level. For non-inferiority testing, the difference in sensitivity between CT and MRI was calculated. The level of signi cance was set at 5%. ROC curves and interobserver agreement were calculated.Results On patient level, MRI had 98% sensitivity and 75% speci city compared to CT. On lesion level within each modality, MRI had 99% sensitivity and 78% speci city, whereas CT had 98% sensitivity and 88% speci city. MRI sensitivity was non-inferior to CT (difference 0.57% (95% CI -1.4-2.5%)). The interobserver agreement was substantial between CT and MRI.Conclusion MRI with DWIBS was non-inferior to contrast-enhanced CT in detecting metastatic TC disease.Trial registration www.clinicaltrials.gov NCT03436901, nished July 1 st 2021.

This study indicates that radial subluxation may not be an important factor in symptoms and function in patients with symptomatic TMC osteoarthritis without severe scaphotrapezio (ST) joint degeneration. In addition, preoperative subluxation seems not to be important for the result after total joint arthroplasty.

Purpose Concerns of imaging-related radiation in young patients with high survival rates have increased the use of magnetic resonance imaging (MRI) in testicular cancer (TC) stage I. However, computed tomography (CT) is still preferred for metastatic TC. The purpose of this study was to compare whole-body MRI incl. diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) with contrast-enhanced, thoracoabdominal CT in metastatic TC.Methods A prospective, non-inferiority study of 84 consecutive patients (median age 33 years) with newly diagnosed metastatic TC (February 2018 - January 2021). Exclusion criteria were age <18 years, claustrophobia and MRI contraindications. Patients had both MRI and CT before and after treatment. Anonymised images were reviewed by experienced radiologists.Lesion malignancy was evaluated on a Likert scale (1 benign – 4 malignant). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated on patient and lesion level. For non-inferiority testing, the difference in sensitivity between CT and MRI was calculated. The level of significance was set at 5%. ROC curves and interobserver agreement were calculated.Results On patient level, MRI had 98% sensitivity and 75% specificity compared to CT. On lesion level within each modality, MRI had 99% sensitivity and 78% specificity, whereas CT had 98% sensitivity and 88% specificity. MRI sensitivity was non-inferior to CT (difference 0.57% (95% CI -1.4-2.5%)). The interobserver agreement was substantial between CT and MRI. Conclusion MRI with DWIBS was non-inferior to contrast-enhanced CT in detecting metastatic TC disease. Trial registration www.clinicaltrials.gov NCT03436901, finished July 1st 2021.