Testicular microlithiasis and preliminary experience of acoustic radiation force impulse imaging

Abstract

BackgroundElastography of the testis can be used as a part of multiparametric examination of the scrotum.PurposeTo determine the testicular stiffness using acoustic radiation force impulse imaging (ARFI) technique in men with testicular microlithiasis (TML).Material and MethodsIn 2013, 12 patients with diagnosed testicular microlithiasis in 2008 (mean age, 51 years; age range, 25–76 years) underwent a 5-year follow-up B-mode ultrasonography with three ARFI elastography measurements of each testis. We used a Siemens Acuson S3000 machine.ResultsNo malignancy was found at the 5-year follow-up B-mode and elastography in 2013. However, we found an increase in TML; in the previous ultrasonography in 2008, eight men had bilateral TML, whereas in 2013, 10 men were diagnosed with bilateral TML. The mean elasticity of testicles with TML was 0.82 m/s (interquartile range [IQR], 0.72–0.88 m/s; range, 65–1.08 m/s).ConclusionElastography velocity of testis with TML seems to be in the same velocity range as in men with normal testis tissue.

The role of ARFI elastography to evaluate microstructrual changes of patients with testicular microlithiasis

“…Our study results were also similar to the study by D'Anastasia et al (7). Pedersen et al (14) found that the SWV range of microlithiasis areas of adults with TML to be 0.65-1.08 m/s and their study results demonstrated no significant difference between normal testes and testes with TML. In our study, the mean SWV range of testicles with TML was higher than the SWV range in the study by Pedersen et al…”

“…Studies in the literature have shown that none of the patients with TML developed testicular cancer after five-year follow-up in the adult group. However, there was no significant SWV difference between the patient group and the control group in a study (14). In our study, there was a statistically significant difference between the testicular SWV of the patient group and the control group.…”

“…The study by Pedersen et al. (14) reported that no testicular cancer developed in patients with TML after the follow-up period of five years; as a result, TML alone may not be a risk factor for testicular cancer. There is still a need for further studies to validate these findings.…”

“…Previous studies with the pediatric group on this subject are not available in the literature. For this reason, the sampling interval was determined based on the study performed by Pedersen et al (14). At 95% accuracy, the number of cases required to demonstrate the difference between the patient and control groups was calculated as at least 11 patients.…”

Limitations and opportunities of non-invasive liver stiffness measurement in children

“…Acoustic radiation force impulse (ARFI) is a point shear wave elastography that measures tissue elasticity independent of an external mechanical impulse to the tissue. Therefore, this method is not only useful for liver stiffness measurement but also for determination of changes in stiffness of the spleen[ 48 ], testis[ 49 ], thyroid[ 50 ], breast[ 51 ], placenta[ 52 ], pancreas in chronic pancreatitis[ 53 ] and transplanted kidney[ 54 ]. The technique is based on an acoustic impulse and measurement of the speed of the shear wave induced by it; results are displayed in m/s.…”