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MRI of testicular malignancies

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Abstract

Although testicular carcinoma represents approximately only 1% of solid neoplasms in men, it is the most common malignancy between young men. The two main histologic categories are testicular germ cell tumors (TGCTs), including seminomas and nonseminomas, accounting for 90–95% of testicular neoplasms and sex cord-stromal tumors. Scrotal MRI, including a multiparametric protocol, has been proposed as a valuable supplemental imaging technique in the investigation of testicular pathology. Recently, the Scrotal and Penile Imaging Working Group appointed by the board of the European Society of Urogenital Radiology has produced recommendations on when to perform scrotal MRI. Regarding intratesticular masses, MRI of the scrotum may be used for their characterization, when US findings are indeterminate and for local staging of TGCTs, when organ-sparing surgery is planned. Differentiation between seminomas and nonseminomas is possible based on MRI features, when clinically needed. Scrotal MRI may also help in differentiating between TGCTs and nongerm cell tumors. Functional information based on diffusion-weighted imaging and dynamic contrast-enhanced MRI data improve testicular mass lesion characterization. Preliminary observations on diffusion tensor imaging, magnetization transfer imaging, and proton MR spectroscopy bring about new data in the understanding of testicular microstructure and pathophysiology.

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Authors and Affiliations

  1. Department of Clinical Radiology, Medical School, University of Ioannina, University Campus, 45110, Ioannina, Greece

    Athina C. Tsili, Efrosyni Stiliara & Maria I. Argyropoulou

  2. Department of Urology, Medical School, University of Ioannina, University Campus, 45110, Ioannina, Greece

    Nikolaos Sofikitis

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  1. Athina C. Tsili
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  2. Nikolaos Sofikitis
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  4. Maria I. Argyropoulou
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Correspondence to Athina C. Tsili.

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Tsili, A.C., Sofikitis, N., Stiliara, E. et al. MRI of testicular malignancies. Abdom Radiol 44, 1070–1082 (2019). https://doi.org/10.1007/s00261-018-1816-5

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