MRI of the scrotum: Recommendations of the ESUR Scrotal and Penile Imaging Working Group

Tsili, Athina C.; Bertolotto, Michele; Turgut, Ahmet Tuncay; Dogra, Vikram S.; Freeman, Simon; Rocher, Laurence; Belfield, Jane; Studniarek, Michał; Ntorkou, Alexandra; Derchi, Lorenzo E.; Oyen, Raymond; Ramchandani, Parvati; Seçil, Mustafa; Richenberg, Jonathan

doi:10.1007/s00330-017-4944-3

Cited by 63 publications

(97 citation statements)

References 75 publications

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“…Currently, scrotal MRI is considered an effective, complementary diagnostic tool for the investigation of abnormal testis (Aganovic & Cassidy, 2012; Mathur, Mills, & Spektor, 2017; Tsili et al, 2014, 2018). 1H‐MRS has recently been added as an adjunct tool to conventional MRI that might serve as a bridge between metabolism and anatomical and physiological changes taking place within previously determined VOIs in normal and pathologic testis (Aaronson et al, 2010; Baleato‐Gonzalez et al, 2015; Firat et al, 2008; Parenti et al, 2016; Storey et al, 2018; Tsili et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Adhesive patch and belts were also used to immobilise scrotum and avoid motion artefacts. The penis was draped on the lower anterior abdominal wall, by means of an adhesive tape (Tsili et al, 2018). Conventional spin‐echo T1‐weighted imaging (T1WI) and fast spin‐echo T2‐weighted imaging (T2WI) in three orthogonal planes were used for data analysis.…”

Section: Methodsmentioning

confidence: 99%

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Are there differences in the biochemical profile of bilateral normal testes? A 3.0 T 1H‐MR spectroscopy study

et al. 2020

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Bilateral normal testes asymmetry represents an interesting phenomenon. The aim was to assess possible differences in the biochemical profile of bilateral normal testes by 3.0 T proton magnetic resonance spectroscopy (1H‐MRS). Twenty‐one men were examined with scrotal 3.0 T MRI, including a single‐voxel point‐resolved spectroscopy sequence. MR spectra were obtained by placing a volume of interest in the middle of each normal testis. Normalised metabolite concentrations, defined as ratios of the calculated metabolite concentrations relative to creatine (Cr) concentration, were compared between bilateral normal testes using Mann–Whitney U test. 1H‐MRS allowed the detection of certain testicular metabolites, including total choline, Cr, myo‐inositol, Glx, total lipids and macromolecules resonating at 0.9, 1.3 and 2.0 ppm. Normal left testis had higher median normalised concentrations of Glx (p = .002) and lactate (p = .041) compared with the normal right testis. Differences in concentrations of Glx were attributed to differences in glutamate (p = .020). Normal testes asymmetry is confirmed in this study by differences in the biochemical testicular profile, as assessed by 3.0 T 1H‐MRS. Increase in levels of glutamate and lactate in normal left testis should be correlated with changes in metabolic pathways, specifically glycometabolism and amino acid metabolism.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Are there differences in the biochemical profile of bilateral normal testes? A 3.0 T 1H‐MR spectroscopy study

et al. 2020

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“…Scrotal MR imaging should be performed with a 1.5-T magnet and a phased-array surface coil, and the testes should be elevated with a folded towel placed between the thighs, under the scrotal sac (4). An institutional MR imaging protocol is provided in Table 1.…”

Section: Mr Imaging Imaging Protocol and Normal Appearance Of The Testesmentioning

confidence: 99%

“…The mean ADC values for normal testicular parenchyma are in the range of 1.08-1.31 3 10 -3 mm 2 /sec, depending on patient age, and are lower in malignant lesions than in benign lesions or normal tissue (8,9). Axial T1weighted imaging with an extended or large field of view is used to image the abdomen and pelvis when cryptorchidism or malignancy is suspected, to exclude metastasis (4).…”

Section: Introductionmentioning

confidence: 99%

Spectrum of Extratesticular and Testicular Pathologic Conditions at Scrotal MR Imaging

et al. 2018

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Diagnostic workup of scrotal lesions should begin with a complete clinical history and physical examination, including analysis of risk factors such as family history of testicular cancer, personal history of tumor in the contralateral testis, and cryptorchidism, followed by imaging. Scrotal ultrasonography (US) with a combination of gray-scale and color Doppler techniques has been the first-line imaging modality for evaluation of testicular and extratesticular lesions because of its low cost, wide availability, and high diagnostic accuracy. However, US has limitations related to operator dependence, the relatively small field of view, and lack of tissue characterization. Magnetic resonance (MR) imaging, because of its superior soft-tissue contrast and multiplanar capabilities, is increasingly being used as a supplemental diagnostic problem-solving tool in cases where scrotal US findings are inconclusive or nondiagnostic. In addition to morphology, lesion location, and tissue characterization (eg, fat, blood products, granulation tissue, and fibrosis), scrotal MR imaging provides important information that can affect surgical planning and improve patient care. MR imaging also is helpful for differentiating testicular and extratesticular lesions, distinguishing between benign and malignant lesions, and evaluating the local extent of disease. This review discusses the anatomy and MR imaging features of testicular and extratesticular neoplastic and nonneoplastic conditions and describes relevant MR imaging techniques. RSNA, 2018 Contact information that appeared in the print version of this article was updated in the online version on May 14, 2018.

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“…Currently, ultrasonography (US) is the initial imaging method for confirming the existence of a testicular mass (5, 12). MRI has emerged as a valuable modality that can be an alternative diagnostic tool, especially in cases of non-diagnostic or equivocal sonographic findings (13). Compared to US, MRI can provide more abundant anatomical and functional information and is less dependent on operator technique.…”

Section: Introductionmentioning

confidence: 99%

T2-Weighted Image-Based Radiomics Signature for Discriminating Between Seminomas and Nonseminoma

et al. 2019

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Objective: To evaluate the performance of a T2-weighted image (T2WI)-based radiomics signature for differentiating between seminomas and nonseminomas.Materials and Methods: In this retrospective study, 39 patients with testicular germ-cell tumors (TGCTs) confirmed by radical orchiectomy were enrolled, including 19 cases of seminomas and 20 cases of nonseminomas. All patients underwent 3T magnetic resonance imaging (MRI) before radical orchiectomy. Eight hundred fifty-one radiomics features were extracted from the T2WI of each patient. Intra- and interclass correlation coefficients were used to select the features with excellent stability and repeatability. Then, we used the minimum-redundancy maximum-relevance (mRMR) and the least absolute shrinkage and selection operator (LASSO) algorithms for feature selection and radiomics signature development. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of the radiomics signature.Results: Five features were selected to build the radiomics signature. The radiomics signature was significantly different between the seminomas and nonseminomas (p < 0.01). The area under the curve (AUC), sensitivity, and specificity of the radiomics signature for discriminating between seminomas and nonseminomas were 0.979 (95% CI: 0.873–1.000), 90.00 (95% CI: 68.3–98.8), and 100.00 (95% CI: 82.4–100.0), respectively.Conclusion: The T2WI-based radiomics signature has the potential to non-invasively discriminate between seminomas and nonseminomas.

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MRI of the scrotum: Recommendations of the ESUR Scrotal and Penile Imaging Working Group

Abstract: • This report presents recommendations for magnetic resonance imaging (MRI) of the scrotum. • Imaging acquisition protocols and clinical indications are provided. • MRI is becoming established as a worthwhile second-line diagnostic tool for scrotal pathology.

Cited by 63 publications

References 75 publications

Are there differences in the biochemical profile of bilateral normal testes? A 3.0 T 1H‐MR spectroscopy study

Are there differences in the biochemical profile of bilateral normal testes? A 3.0 T 1H‐MR spectroscopy study

Spectrum of Extratesticular and Testicular Pathologic Conditions at Scrotal MR Imaging

T2-Weighted Image-Based Radiomics Signature for Discriminating Between Seminomas and Nonseminoma

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