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Multiparametric ultrasound for the assessment of testicular lesions with negative tumoral markers


1 Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
2 Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China
3 Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
4 National Clinical Research Center for Interventional Medicine, Shanghai 200072, China
5 Department of Ultrasound, Zhongshan Hospital, Fudan University, Institute of Ultrasound in Medicine and Engineering, Shanghai 200032, China

Correspondence Address:
Hui-Xiong Xu,
Department of Ultrasound, Zhongshan Hospital, Fudan University, Institute of Ultrasound in Medicine and Engineering, Shanghai 200032
China
Li-Ping Sun,
Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072; National Clinical Research Center for Interventional Medicine, Shanghai 200072
China
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aja202235

The purpose of this study was to evaluate the diagnostic performance of multiparametric ultrasound (mpUS; grayscale US, color Doppler US, strain elastography, and contrast-enhanced US) in the assessment of testicular lesions with negative tumoral markers. MpUS imaging data, patient age, serum tumor markers, scrotal pain, cryptorchidism, and related clinical information were retrospectively collected for patients who underwent mpUS examination between January 2013 and December 2019. Histologic results or follow-up examinations were used as the reference standard. In total, 83 lesions from 79 patients were included in the analysis. Fifty-six patients were finally diagnosed with benign tumors, and 23 patients were ultimately diagnosed with malignant tumors. Chi-square tests or Fisher's exact tests were used to assess the difference between the two groups. Stepwise multivariate logistic regression analysis showed that lesion diameter (odds ratio [OR] = 1.072, P = 0.005), vascularization on color Doppler US (OR = 4.066, P = 0.001), and hyperenhancement during the early phase (OR = 6.465, P = 0.047) were significant independent risk factors for malignancy; however, when compared with neoplastic lesions, pain (OR = 0.136, P < 0.001), absence of vascularization on color Doppler US (OR = 1.680, P = 0.042), and nonenhancement during the late phase (OR = 3.461, P = 0.031) were strongly associated with nonneoplastic lesions. MpUS features are useful for differentiating testicular lesions with negative tumoral markers and improving the preoperative diagnosis, which may avoid inappropriate radical orchiectomy.


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