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30.08.2017 | Urogenital

Dynamic contrast-enhanced and diffusion-weighted MR imaging in the characterisation of small, non-palpable solid testicular tumours

verfasst von: Lucia Manganaro, Matteo Saldari, Carlotta Pozza, Valeria Vinci, Daniele Gianfrilli, Ermanno Greco, Giorgio Franco, Maria Eleonora Sergi, Michele Scialpi, Carlo Catalano, Andrea M. Isidori

Erschienen in: European Radiology | Ausgabe 2/2018

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Abstract

Objectives

To explore the role of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), using semiquantitative and quantitative parameters, and diffusion-weighted (DW) MRI in differentiating benign from malignant small, non-palpable solid testicular tumours.

Methods

We calculated the following DCE-MRI parameters of 47 small, non-palpable solid testicular tumours: peak enhancement (PE), time to peak (TTP), percentage of peak enhancement (Epeak), wash-in-rate (WIR), signal enhancement ratio (SER), volume transfer constant (K_trans), rate constant (K_ep), extravascular extracellular space volume fraction (V_e) and initial area under the curve (_iAUC). DWI signal intensity and apparent diffusion coefficient (ADC) values were evaluated.

Results

E_peak, WIR, K_trans , K_ep and iAUC were higher and TTP shorter in benign compared to malignant lesions (p < 0.05). All tumours had similar ADC values (p > 0.07). Subgroup analysis limited to the most frequent histologies – Leydig cell tumours (LCTs) and seminomas – replicated the findings of the entire set. Best diagnostic cutoff value for identification of seminomas: K_trans ≤0.135 min⁻¹, K_ep ≤0.45 min⁻¹, iAUC ≤10.96, WIR ≤1.11, Epeak ≤96.72, TTP >99 s.

Conclusions

DCE-MRI parameters are valuable in differentiating between benign and malignant small, non-palpable testicular tumours, especially when characterising LCTs and seminomas.

Key Points

• DCE-MRI may be used to differentiate benign from malignant non-palpable testicular tumours.

• Seminomas show lower Ktrans, Kep and iAUC values.

• ADC values are not valuable in differentiating seminomas from LCTs.

• Semiquantitative DCE-MRI may be used to characterise small, solid testicular tumours.

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Titel: Dynamic contrast-enhanced and diffusion-weighted MR imaging in the characterisation of small, non-palpable solid testicular tumours
verfasst von: Lucia Manganaro
Matteo Saldari
Carlotta Pozza
Valeria Vinci
Daniele Gianfrilli
Ermanno Greco
Giorgio Franco
Maria Eleonora Sergi
Michele Scialpi
Carlo Catalano
Andrea M. Isidori
Publikationsdatum: 30.08.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5013-7

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Dynamic contrast-enhanced and diffusion-weighted MR imaging in the characterisation of small, non-palpable solid testicular tumours