¹⁸F‐FDG PET/CT use in functional assessment of the testes: A systematic review

Abstract

Introduction:Our study analysed previous studies employing positron emission tomography with co-registered computer tomography (PET/CT) in andrological patient evaluation and assessed the differences in 2-[ 18 F]F-fluoro-2′-deoxyglucose (FDG) uptake between three groups: healthy testes, benign and malignant testicular pathology.Methods: Medline and Embase were systematically searched for studies involving FDG-PET/CT imaging of testes with results expressed as mean standardised uptake value (SUV mean ). A one-way ANOVA was used to compare SUV mean between three groups. All papers assessing andrological parameters were pooled to compare fertility data.Results: Seventeen studies, including three relating to fertility diagnosis, with a total of 830 patients, were included in the review. One-way ANOVA showed a statistical difference between mean values of tracer SUV mean in healthy and malignant testes (Dif. = −2.77, 95% CI = −4.32 to 1.21, p < 0.01) as well as benign and malignant (Dif. = −2.95, 95% CI = −4.33 to −1.21, p < 0.01) but no difference between healthy and benign (Dif. = 0.19, 95% CI = −0.96 to 1.33, p = 0.90). There is some evidence to suggest that FDG uptake and testicular volume are positively correlated to total sperm count, sperm concentration and sperm motility and that germ cells are likely to account for the majority of testicular FDG accumulation. Conclusion:Our findings indicate that malignant testicular lesions demonstrate a significantly higher FDG uptake than benign testicular lesions or healthy testes. Some evidence also suggests that FDG-PET could visualise metabolic activity and thus spermatogenesis; however more studies are required to determine whether FDG-PET could also be used to diagnose infertility. Further studies should focus on correlating both sex hormone-serum levels and semen analysis results with imaging data.

Chemically engineering cells for precision medicine

“…This design allows anatomic mapping of different biochemical pathways and physiological processes like protein expression through the detection of gamma rays that can produce three-dimensional images to show the location, concentration, and bioactivities of tracers. PET imaging is versatile in its uses and has numerous applications in a multitude of diagnosis, such as assessment of the testes, 189 metabolic imaging of the pain matrix in patients, 190 soft tissue injury imaging, 191 and drug discovery and development.…”

Imaging andrology of the future: Where functional imaging embraces the clinic

“…Tissue elastography may have a role in differentiating focal non-neoplastic lesions, such as ischemia or abscesses, from tumors, and may contribute to determining benign from malignant neoplasms. 16 In non-obstructive azoospermic patients, shear wave elastography (SWE) may predict sperm retrieval, 17 thus improving patient management in centers for assisted reproduction. The intra-testicular lesions can be differentiated based on CEUS; malignant intratesticular Andrology.…”

“…The introduction of CEUS and elastography techniques has added the option of multiparametric US imaging in the differential diagnosis of intratesticular lesions, mainly when these lesions are small and nonpalpable. Tissue elastography may have a role in differentiating focal non‐neoplastic lesions, such as ischemia or abscesses, from tumors, and may contribute to determining benign from malignant neoplasms 16 …”