Differentiation of testicular seminoma and nonseminomatous germ cell tumor on magnetic resonance imaging

Liu, Renwei; Lei, Zhengxian; Li, Aibo; Jiang, Yixiang; Ji, Jiayin

doi:10.1097/md.0000000000017937

Cited by 17 publications

(20 citation statements)

References 16 publications

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“…DW imaging showed no restricted diffusion in the inflammatory granuloma. Seminoma mainly occurs in young adults and shows uniform or uneven isointensity on T1WI, hypointensity on T2WI, and the presence of hypointense fibrovascular septa on T2WI that show slight enhancement with enhanced fibrous septa [16] . The lesions showed different degrees of hyperintensity on DWI.…”

Section: Discussionmentioning

confidence: 99%

MRI features of testicular spermatic granuloma

Liu

Yang²,

Huo³

et al. 2022

Medicine

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This is a meta-analysis to compare the results between laminoplasty and laminectomy followed by fusion for the patients with multilevel cervical compressive myelopathy. An extensive search of literature was performed in MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG. The following outcome measures were extracted: the Japanese Orthopaedic Association (JOA) scores, cervical curvature index (CCI), visual analog scale (VAS), cervical lordosis (C2–7), complications, blood loss, and operation time. Data analysis was conducted with RevMan 5.3 and STATA 12.0. A total of 23 studies comprising 774 and 743 patients treated with laminoplasty and laminectomy followed by fusion, respectively, were included in the final analysis. The pooled analysis showed that there was no significant difference in preoperative JOA scores [P = 0.89], postoperative JOA scores [P = 0.13], JOA scores improvement rate [P = 0.27], preoperative CCI [P = 0.15], postoperative CCI [P = 0.14], preoperative VAS [P = 0.41], postoperative VAS [P = 0.52], preoperative cervical lordosis (C2–7) [P = 0.46], postoperative cervical lordosis (C2–7) [P = 0.67], total complications [P = 0.07], axial pain [P = 0.94], and blood loss [P = 0.51]. However, there were significant difference in operation time (WMD = −19.57 [−32.11, −7.02], P = 0.002) and C5 palsy (OR = 0.26 [0.15, 0.44], P < 0.001). As compared with laminectomy followed by fusion, expansive laminoplasty showed no significant differences in JOA scores, CCI, ROM, VAS, cervical lordosis (C2–7), axial pain, total complications, and blood loss, but shorter operation time and fewer C5 palsy.

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Section: Discussionmentioning

confidence: 99%

MRI features of testicular spermatic granuloma

Liu

Yang²,

Huo³

et al. 2022

Medicine

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“…The literature search found a total of 1106 articles (tumors, n = 584; acute scrotum, n = 193; undescended testes, n = 178; and infertility, n = 151). Ultimately, 83 articles were deemed relevant and used as the literature basis of this review (tumors, n = 50; acute scrotum, n = 6; undescended testes, n = 7; and infertility, n = 20) 6–9,13,24–33,35,43,48–110 . The flow chart of the selection process is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

When to ask for an MRI of the scrotum

et al. 2021

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Background: Multiparametric MRI (mpMRI) of the scrotum has been established as a useful second-line diagnostic tool for the investigation of scrotal diseases. Recently, recommendations on clinical indications for scrotal MRI were issued by the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology. Objective: To update current research on when to ask for an MRI of the scrotum. Methods: PubMed database was searched for original articles and reviews published during 2010-2021.Results: Eighty-three articles fulfilled the search criteria. Scrotal MRI is mainly recommended after inconclusive US findings or inconsistent with the clinical examination and should be asked in the following cases: differentiation between intratesticular and paratesticular lesions (in rare cases of uncertain US findings), characterization of paratesticular and intratesticular lesions (when US findings are indeterminate), discrimination between germ cell and sex cord-stromal testicular tumors, local staging of testicular malignancies (in patients planned for testis-sparing surgery), differentiation between seminomas and non-seminomatous tumors (when immediate chemotherapy is planned and orchiectomy is delayed), assessment of acute scrotum and scrotal trauma (rarely needed, in cases of non-diagnostic US findings) and detection and localization of undescended testes (in cases of inconlusive US findings). Although preliminary data show promising results in the evaluation of male infertility, no established role for mpMRI still exists. Conclusion:Multiparametric MRI of the scrotum, by assessing morphologic and functional data represents a valuable problem-solving tool, helping to improve our understanding on the nature of scrotal pathology and the process of spermatogenesis. The technique may improve patient care and reduce the number of unnecessary surgical procedures.

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“…Seminomas are multiloculated solid masses divided by fibrovascular septa. Seminomas appear as a hypointense signal on T2W imaging due to the density of tumor cells and their low water content relative to normal spermatogenic cells (15). The septa are hypointense on T2W imaging and intensely enhanced after administration of contrast (16).…”

Section: Discussionmentioning

confidence: 99%

The utility of diffusion-weighted imaging and ADC values in the characterization of mumps orchitis and seminoma

Liu

Jiang

et al. 2021

Acta Radiol

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Background Diffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and quantitative analysis of a disease. Purpose To characterize testicular lesions that present as a hypointense signal on magnetic resonance imaging (MRI) T2-weighted images using DWI. Material and Methods Study participants were divided into three groups. Group A were healthy controls (n = 35), group B included patients with mumps orchitis (n = 20), and group C included patients with seminoma (n = 15). DWI sequences used b-values of 0, 1000, and 2000 s/mm2. Apparent diffusion coefficient (ADC) values between 1000 and 2000 s/mm2 were calculated by MRI postprocessing software. The Kruskal–Wallis test and receiver operating characteristic analysis were performed to evaluate how well ADC values distinguished between mumps orchitis and seminoma. Results Normal testicular tissue showed a hyperintense signal on DWI and hypointensity on the ADC map: mean ADC value was 0.77 (0.69–0.85) ± 0.08 ×10−3 mm2/s. Mumps orchitis and seminoma showed slight hyperintensity on DWI: mean ADC values were 0.85 (0.71–0.99) ± 0.15 ×10−3 mm2/s and 0.43 (0.39–0.47) ± 0.04 × 10−3 mm2/s, respectively. There were statistically significant differences in mean ADC values between normal testicular tissue and seminoma and between mumps orchitis and seminoma. The cutoff ADC value for differentiating seminoma from mumps orchitis was 0.54 × 10−3 mm2/s. The sensitivity, specificity, and Youden Index for diagnosing seminoma were 99%, 31%, and 30%, respectively. Conclusion High b-value DWI has potential utility for differentiating mumps orchitis from seminoma in the clinical setting.

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Differentiation of testicular seminoma and nonseminomatous germ cell tumor on magnetic resonance imaging

Cited by 17 publications

References 16 publications

MRI features of testicular spermatic granuloma

MRI features of testicular spermatic granuloma

When to ask for an MRI of the scrotum

The utility of diffusion-weighted imaging and ADC values in the characterization of mumps orchitis and seminoma

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