Role of multiparametric ultrasound in testicular focal lesions and diffuse pathology evaluation, with particular regard to elastography: Review of literature

Abstract

Background: Ultrasound is the main requested technique for the assessment of traumatic, vascular, neoplastic, and inflammatory testicular pathology. Moreover, the role of ultrasound has broadened over the years along with the introduction of new techniques, such as contrast enhanced ultrasound and ultrasound elastography.Objective: An updated representation of the pre-existing Literature evidence for multiparametric ultrasound imaging with particular regard to elastography, in the evaluation of focal and diffuse testicular pathologies, has been presented. Methods:The search was performed in PubMed, Cochrane, EMBASE, Web of Science and Scopus databases from the earliest available article (1977) until January 2021.Based on the evidence of the Literature, the current role of US imaging for focal and diffuse testicular pathologies has been reported and illustrated, with emphasis on examination technique, classification, and pitfalls. Results: Multiparametric Ultrasound has a recognized role for testicle focal and diffuse disease. Elastography is nowadays recognized as an essential part of the multiparametric ultrasound examination. However, in the setting of testicular pathology this method showed some promising results in the setting of varicocoele and for focal lesions characterization. In the remaining field its role is still under debate.Discussion: B-mode ultrasound and color Doppler ultrasound have been for a long time the diagnostic gold standard for testicular pathologies. The introduction of both contrast enhanced ultrasound and elastography in the last two decades has brought to the emergence of the multiparametric ultrasound concept. These methods are currently able to increase diagnostic confidence especially for testicular lesions characterization, with different relevance depending on the pathology under consideration.

Cytological spectrum of testicular malignancies with histopathological correlation: A retrospective analysis

“…Human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP), are particularly valuable for the detection of non-seminomatous tumors. 10 Although the incidence of testicular cancer is on rise, the survival has improved due to advancements in chemotherapeutic regimens. 11 There are very few studies in published literature describing the cytological spectrum of testicular tumors.…”

“…Initial evaluation of testicular tumors includes tumor marker levels and scrotal ultrasonography. Human chorionic gonadotropin (HCG) and alpha‐fetoprotein (AFP), are particularly valuable for the detection of non‐seminomatous tumors 10 . Although the incidence of testicular cancer is on rise, the survival has improved due to advancements in chemotherapeutic regimens 11 …”

Assessment of testicular stiffness in fertile dogs with shear wave elastography techniques: a pilot study

“…In human medicine, testicular stiffness has been investigated by elastography in both physiological (10) and pathological testes (11)(12)(13)(14)(15)(16)(17)(18). Elastography has been applied for the evaluation of undescended testes, infertility, testicular torsion, tumors, microlithiasis, varicocele and segmental testicular infarction (18), and has shown efficacy in the diagnosis of varicocele (19) and in discriminating focal non-neoplastic lesions from neoplasms, and benign from malignant testicular tumors (20). This technique also showed to be useful in predicting the postoperative improvement in some sperm parameters in patients subjected to varicelectomy (21).…”

Multiparametric ultrasound-based assessment of overt hyperthyroid diffuse thyroid disease

“…Ultrasound remains the primary morphological tool for thyroid disease diagnosis, both nodular and diffuse. Multiparametric ultrasound evaluation is used in the differential diagnostic of focal liver ( 10 ) and pancreatic lesions, breast ( 11 , 12 ), thyroid ( 13 – 17 ), cervical lymph nodes ( 18 )or testicular ( 19 – 21 ) nodular disease. Combining the information from gray scale US, doppler, elastography and contrast enhanced ultrasound do offer valuable information also in diffuse diseases such as salivary gland ( 22 ) or liver ( 23 , 24 ).…”