Diffusion-weighted magnetic resonance imaging in the characterization of testicular germ cell neoplasms: Effect of ROI methods on apparent diffusion coefficient values and interobserver variability

Tsili, Athina C.; Ntorkou, Alexandra; Astrakas, Loukas G.; Xydis, Vasileios; Tsampalas, Stavros; Sofikitis, Nikolaos; Argyropoulou, Maria I.

doi:10.1016/j.ejrad.2017.01.017

Cited by 17 publications

(20 citation statements)

References 25 publications

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“…However, this needs to be validated in a larger patient cohort as ADC and SWE could serve as a non-invasive tool for histological differentiation. Non-seminoma tumors had less diffusion restriction with a higher ADC mean compared to seminoma tumors (Table 2), confirming previous results (25). SWE showed an increased stiffness in non-seminomas compared to seminomas, which has not been reported previously.…”

Section: Discussionsupporting

confidence: 90%

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Elastography and diffusion-weighted MRI in patients with testicular microlithiasis, normal testicular tissue, and testicular cancer: an observational study

et al. 2018

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Background Ultrasound elastography is increasingly available in clinical practice. Recent studies showed higher velocity stiffness in testicular tumors compared to normal testicles. Purpose To evaluate ultrasound elastography in combination with the apparent diffusion coefficient measurements in diffusion weighted (DW) magnetic resonance imaging (MRI) in testicles. DW can be a useful tool in evaluating testicular malignancies. However, the relationship between velocity stiffness and MRI diffusion is not well established. Material and Methods We prospectively included 132 patients with testicular microlithiasis (n = 53), or normal testicular tissue (n = 53), or suspected for testicular cancer (n = 26). All 132 patients underwent ultrasonography including shear wave elastography and MRI diffusion coefficient examination of the scrotum. Results No clinically relevant difference in velocity stiffness was found between normal and testicles with microlithiasis. There was a significant difference in stiffness between patients with testicular microlithiasis (0.78 m/s), normal testicular tissue (0.77 m/s), and patients with testicular cancer (1.95 m/s) ( P ≤ 0.001). Similarly, there was a statistically significant difference in MRI diffusion values between patients with testicular microlithiasis (0.978 × 10mms), normal testicular tissue (0.929 × 10mms), and testicular cancers (0.743 × 10mms) ( P < 0.01). Conclusion Patients with testicular microlithiasis had no malignant characteristics measured with shear wave elastography or MRI diffusion. MRI diffusion and elastography may be useful to preoperatively differentiate benign from malignant testicular lesions.

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Section: Discussionsupporting

confidence: 90%

“…Non-seminoma tumors had less diffusion restriction with a higher ADC mean compared to seminoma tumors (Table 2), confirming previous results (25). SWE showed an increased stiffness in non-seminomas compared to seminomas, which has not been reported previously.…”

Section: Discussionsupporting

confidence: 89%

Elastography and diffusion-weighted MRI in patients with testicular microlithiasis, normal testicular tissue, and testicular cancer: an observational study

et al. 2018

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“…However, the number of patients was limited to 21 cases and the interpretation of MRI findings will always be dependent on radiologist expertise. Other studies have focused on quantitative MRI imaging, such as DWI with ADC values giving promising results in discriminating SGCT-NSGCT status with an AUC of 0.906 9,10,28,29 . The robustness of these results was also proven against different ROI definitions 28 .…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have focused on quantitative MRI imaging, such as DWI with ADC values giving promising results in discriminating SGCT-NSGCT status with an AUC of 0.906 9,10,28,29 . The robustness of these results was also proven against different ROI definitions 28 . Furthermore, dynamic contrast enhanced (DCE)-MRI has been also proven to be a valuable semi-quantitative method to discriminate TGCT and TNGCT lesions with a maximum AUC of 0.89; however, these methods do not provide numerical data for a standardized assessment 10 .…”

Section: Discussionmentioning

confidence: 99%

The potential role of MR based radiomic biomarkers in the characterization of focal testicular lesions

Feliciani

Mellini

Carnevale

et al. 2021

Sci Rep

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How to differentiate with MRI-based techniques testicular germ (TGCTs) and testicular non-germ cell tumors (TNGCTs) is still under debate and Radiomics may be the turning key. Our purpose is to investigate the performance of MRI-based Radiomics signatures for the preoperative prediction of testicular neoplasm histology. The aim is twofold: (i), differentiating TGCTs and TNGCTs status and (ii) differentiating seminomas (SGCTs) from non-seminomatous (NSGCTs). Forty-two patients with pathology-proven testicular neoplasms and referred for pre-treatment MRI, were retrospectively enrolled. Thirty-two out of 44 lesions were TGCTs. Twelve out of 44 were TNGCTs or other histologies. Two radiologists segmented the volume of interest on T2-weighted images. Approximately 500 imaging features were extracted. Least Absolute Shrinkage and Selection Operator (LASSO) was applied as method for variable selection. A linear model and a linear support vector machine (SVM) were trained with selected features to assess discrimination scores for the two endpoints. LASSO identified 3 features that were employed to build fivefold validated linear discriminant and linear SVM classifiers for the TGCT-TNGCT endpoint giving an overall accuracy of 89%. Four features were employed to build another SVM for the SGCT-SNGCT endpoint with an overall accuracy of 86%. The data obtained proved that T2-weighted-based Radiomics is a promising tool in the diagnostic workup of testicular neoplasms by discriminating germ cell from non-gem cell tumors, and seminomas from non-seminomas.

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“…For the small-sample method, a round/oval ROI is placed on the solid portion of the tumor. The effects of ROI methods on ADC measurements have been investigated in some tumors, and each ROI method has its own advantages and disadvantages (27)(28)(29). Wholevolume ROI can reduce inter-or intra-observer variability in ADC measurements; however, it is time-consuming and its application is limited in clinical practice (21,22).…”

Section: Discussionmentioning

confidence: 99%

Effects of region of interest sizes on apparent diffusion coefficient measurements of pleomorphic adenoma, Warthin tumor, and normal parotid parenchyma

Sun¹,

C²,

Dong³

et al. 2019

Quant. Imaging Med. Surg

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Background: Tumor apparent diffusion coefficient (ADC) measurements may be influenced by region of interest (ROI) sizes; however, this effect has not been systematically studied in parotid tumors. Our purpose was to determine the effects of ROI size on ADC measurements for the differentiation of pleomorphic adenoma (PA), Warthin tumor (WT), and normal parotid parenchyma. Methods: Sixty-five patients including 37 with PA (lesions, n=37) and 28 with WT (lesions, n=36) were examined with diffusion-weighted imaging (DWI). Participants with normal contralateral parenchyma of the parotid gland constituted the control group (n=56). The mean ADC values and standard deviations (SDs)

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Diffusion-weighted magnetic resonance imaging in the characterization of testicular germ cell neoplasms: Effect of ROI methods on apparent diffusion coefficient values and interobserver variability

Cited by 17 publications

References 25 publications

Elastography and diffusion-weighted MRI in patients with testicular microlithiasis, normal testicular tissue, and testicular cancer: an observational study

Elastography and diffusion-weighted MRI in patients with testicular microlithiasis, normal testicular tissue, and testicular cancer: an observational study

The potential role of MR based radiomic biomarkers in the characterization of focal testicular lesions

Effects of region of interest sizes on apparent diffusion coefficient measurements of pleomorphic adenoma, Warthin tumor, and normal parotid parenchyma

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