The Diagnostic Value of the Added MR Imaging of the Scrotum in the Preoperative Workup of Sonographically Indeterminate Testicular Lesions—A Retrospective Multicenter Analysis

Cancers, 2022 · DOI: 10.3390/cancers14153594 · Published: July 23, 2022

Simple Explanation

This retrospective multi-center study analyzes the diagnostic accuracy of magnetic resonance imaging (MRI) of the scrotum in comparison with standard ultrasound (US) and histopathological specimens. A total of N = 113 patients were included. A total of 53 histopathological specimens were available, with 52.8% malignant and 50.9% benign ﬁndings. Benign lesions were signiﬁcantly smaller than malignant ones on standard US, MRI and histopathology (all p < 0.05).

Study Duration

June 2008 and April 2021

Participants

n = 113 patients

Evidence Level

Not specified

Key Findings

1
MRI shows good sensitivity and speciﬁcity for the estimation of testicular tumors in this collective.
2
Benign lesions are signiﬁcantly smaller than malignant ones.
3
Both MRI and US can estimate the size of malignant tumors adequately.

Research Summary

The purpose of this study was to retrospectively analyze the diagnostic accuracy of magnetic resonance imaging (MRI) examinations of the scrotum in comparison with standard ultrasound (US) and histopathology. MRI shows good sensitivity and speciﬁcity for the estimation of testicular tumors in this collective. Benign lesions are signiﬁcantly smaller than malignant ones. Both MRI and US can estimate the size of malignant tumors adequately.

Practical Implications

Improved Diagnostic Accuracy

MRI of the scrotum has the potential to improve patient care and reduce the number of unnecessary surgical procedures.

Personalized Treatment Planning

MRI shows good performance of sensitivity and speciﬁcity in the differentiation between malignant and benign lesions and good prediction of the size of the tumors.

Future Research Directions

Prospective trials must address optimal indications, as well as technical details for MRI examinations, to further improve the diagnosis of indeterminate testicular lesions.

Study Limitations

1
Due to the retrospective and multi-center design, some mainly anamnestic data are available from only a few patients.
2
Patients with clearly benign ﬁndings (e.g., varicoceles or similar ﬁndings) in MRI were often not surgically explored. Therefore, a reliable histological diagnosis is missing.
3
The heterogeneity of the examinations at six different clinics because of the lack of established protocols for the examination of the testis (US and MRI) limits the accessibility of the overall cohort.

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