title: Real-Time Elastography and Contrast-Enhanced Ultrasonography in the Evaluation of Testicular Masses: A Comparative Prospective Study.
abstract: This study investigates the usefulness of contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for the characterization of testicular masses by comparing pre-operative ultrasound findings with post-operative histology. Sixty-seven patients with 68 sonographically detected testicular masses underwent B-mode, color-coded Doppler sonography (CCDS), CEUS and RTE according to defined criteria. For RTE, elasticity score (ES), difference of elasticity score (D-ES), strain ratio (SR) and size quotient (Qsize) were evaluated. Histopathologically, 54/68 testicular lesions were neoplastic (47 malignant, 7 benign). Descriptive statistics revealed the following results (neoplastic vs. non-neoplastic) for sensitivity, specificity, positive predictive value, negative predictive value and accuracy, respectively: B-mode, 100%, 43%, 87%, 100%, 88%; CCDS 81%, 86%, 96%, 55%, 82%; CEUS 93%, 85%, 96%, 73%, 91%; ES 98%, 25%, 85%, 75%, 85%; D-ES 98%, 50%, 90%, 83%, 89%; SR 90%, 45%, 86%, 56%, 81%; and Qsize 57%, 83%, 94%, 28%, 61%. B-mode with CCDS remains the standard for assessing testicular masses. In characterization of testicular lesions, CEUS clearly outperformed all other modalities. Our study does not support the routine use of RTE in testicular ultrasonography because of its low specificity.
authors.affiliation: Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Schröder
authors.affiliation: Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany. Electronic address: guntram.lock@albertinen.de.
authors.forename: Guntram
authors.initials: G
authors.lastname: Lock
authors.affiliation: Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany.
authors.forename: Christa
authors.initials: C
authors.lastname: Schmidt
authors.affiliation: Institute of Pathology, Albertinen-Krankenhaus, Hamburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Löning
authors.affiliation: Department of Urology, Albertinen-Krankenhaus, Hamburg, Germany.
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Dieckmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D054459:Elasticity Imaging Techniques / Q000379:methods; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*; D013737:Testis / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods*; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Color-coded ultrasonography; Contrast-enhanced ultrasonography; Elasticity score; Elastography; Seminoma; Strain ratio; Testicle; Testicular neoplasm; Ultrasonography