EFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY ‘Building a European Ultrasound Community’ Young Investigator’s Award EUROSON 2016 Leipzig, Germany 28 October 14.00 – 15.30
7 minutes each for presentation plus 2 minutes discussion
Elastography and diffusion-weighted MRI in patients with normal, testicular microlithiasis and testicular cancer Malene R Pedersen, Henrik Nissen, Henrik Møller, Palle J Osther, Peter Vedsted, Soeren R Rafaelsen 1. Department of Radiology, Vejle Hospital, Demark 2. Cancer Epidemiology and population Health, King’s College London 3. Urological Research center, Fredercia Hospital, Denmark 4. Research Unit for general Practice, Department of public health, Aarhus University, Denmark
ABSTRACT Purpose Today a combination of ultrasonography and elastography is becoming more and more applicable, and both techniques can help to improve an early detection of testicular cancer. Recently, studies have showed higher velocity stiffness in testicular tumours compared with normal testicular tissue. Ultrasound is the primary modality when investigating scrotum, however other modalities and techniques such as diffusion-weighted MRI can be a useful tool in evaluating testicular malignancies. The relationship between velocity stiffness and MRI diffusion is not well established. Our aim was to compare shear wave elastography with MR diffusion weighted apparent diffusion coefficient (ADC). Methods We prospectively examined 126 patients with both ultrasound including a shear wave elastography (Acoustic Radiation Force Impulse) and a MRI diffusion examination of the scrotum. We performed three ARFI measurements in each testicle, and we measured the MRI ADC values in each testicle in three different images. All MRI images were evaluated using an Easy Vis Impax PACS workstation. The patients were divided into three groups; 52 men with normal testicular tissue, 21 men with testicular cancer, and 53 men with testicular microlithiasis. Histology reports from the 21 men with testicular tumours showed 10 seminomas, 9 non- seminoma and 2 of unknown origin. The ADC values were measured in three different images with a region of interest of 3.0 mm, and by freehand whole testicular volume. Results The mean age from the three groups was 46.8 years. The mean tumour elasticity was 2.1 m/s (SD: 2 0.91) and the mean ADC with a Region of interest of 3.0 mm was 0.801 mm /s (SD: 0.23), and with ADC freehand 0.851 (SD 0.22). Conclusion Typically a high measured elastography value indicates increased testicular stiffness, and a low MRI ADC indicates increased testicular stiffness in tumours. But there are exceptions.