The role of VTIQ as a new tissue strain analytics measurement technique in testicular lesions

Abstract

PURPOSE: Virtual touch tissue imaging quantification (VTIQ) is a newly developed technique for the sonographic quantification of tissue elasticity. It has been used in the assessment of breast lesions. The purpose of this study was to determine the diagnostic performance of VTIQ in indeterminate testicular lesions. METHODS: Twenty patients with known testicular pathology underwent conventional B-mode sonography with additional VTIQ of the testicular lesions using a Siemens Acuson S2000™ and S3000™ (Siemens Medical Solutions, Mountain View, CA, USA) system. Tissue mechanical properties were analysed in the VTIQ examination. The pathologic diagnosis was established after surgery or in the follow-up examination for suspected benign lesions. RESULTS: Over 36 months, 22 focal testicular lesions (median lesion size, 18 mm; range, 4-36 mm in 20 patients (median age, 43 years; range, 22-81 years) were examined. Lesions were hyperechoic (n = 1), hypoechoic (n = 14), isoechoic (n = 1), of mixed echogenicity (n = 3) or anechoic (n = 3). Histological examination showed one benign lesion (6.25%) with a mean size of 7 mm and 15 malignant lesions (93.75%) with a mean size of 20 mm. Mean shear wave velocity for normal testicular tissue was 1.17 m/s. No shear wave velocity could be measured in cystic lesions. The rest of the benign lesions showed a mean shear wave velocity of 2.37 m/s. The value of the shear wave velocity in germ cell tumours showed a mean shear wave velocity of 1.94 m/s and for seminoma it showed a mean shear wave velocity of 2.42 m/s. CONCLUSIONS: VTIQ is a reliable new method for measuring qualitative and quantitative stiffness of testicular lesions and tissue. The qualitative shear-wave elastography features were highly reproducible and showed good diagnostic performance in unclear testicular lesions. The VTIQ technique is also useful in assessing small testicular nodules and pseudolesions.

Assessment of Virtual Touch Tissue Imaging Quantification and the Ultrasound Thyroid Imaging Reporting and Data System in Patients With Thyroid Nodules Referred for Biopsy

“…To date, only 1 study reported the application of VTIQ for evaluating thyroid nodules, 22 although VTIQ has been shown to be useful and reproducible in accessing breast lesions and other organs. 19,20,32,33 In this study, the SWV parameters in malignant nodules were all higher than those in benign nodules, and the SWV mean showed the highest AUC value among them, with a cutoff value of 2.90 m/s. By comparison, in a previous study, Azizi et al 22 reported that VTIQ showed an AUC of 0.78 with a cutoff value of 3.54 m/s.…”

Testicular microlithiasis and preliminary experience of acoustic radiation force impulse imaging

“…Trottmann et al. ( 12 ) showed a mean of 1.17 m/s in a normal testicle, and D’Anastasi et al. showed a range of 0.62–1.01 m/s in healthy volunteers ( 6 ).…”

Comparison of Tissue Stiffness Using Shear Wave Elastography in Men with Normal Testicular Tissue, Testicular Microlithiasis and Testicular Cancer

“…Overall, the observed mean velocity in men with testicular cancer was 2.10 m/s, but we found a calculated predicted mean of 1.92 m/s. Trottmann et al investigated seven patients with germ cell tumors and five with seminoma using virtual touch imaging quantification (VTIQ), and the results were a mean shear wave velocity of 1.94 m/s in germ cell tumors and 2.42 m/s in seminoma 22 . Macron et al investigated the testes of 20 healthy patients using SWE and found a mean SWE of 0.81 m/s and a mean VTIQ of 1.07 m/s 28 .…”

“…Elastography is used in various organs 7 9 10 11 and also in the testicles for investigating testicular torsion 12 13 , testicular cancer 14 15 infarction 16 17 , epidermoid cysts 18 , undescended testes 19 , infertile men 20 , hemodialysis patients 21 , testicular microlithiasis, and other lesions 22 23 24 . It can be challenging to distinguish hard tumors in soft tissue using only B-mode ultrasound.…”