MP05-04 CONTRAST-ENHANCED ULTRASOUND (CEUS) AND ELASTOGRAPHY TECHNIQUES IN THE EVALUATION OF UNCLEAR SCROTAL MASSES

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 2016MP05-04 CONTRAST-ENHANCED ULTRASOUND (CEUS) AND ELASTOGRAPHY TECHNIQUES IN THE EVALUATION OF UNCLEAR SCROTAL MASSES Julian Marcon, Matthias Trottmann, Melvin D'Anastasi, Vera Mai, Johannes Rübenthaler, Wael Khoder, Christian G. Stief, Maximilian Reiser, and Dirk-Andre Clevert Julian MarconJulian Marcon More articles by this author , Matthias TrottmannMatthias Trottmann More articles by this author , Melvin D'AnastasiMelvin D'Anastasi More articles by this author , Vera MaiVera Mai More articles by this author , Johannes RübenthalerJohannes Rübenthaler More articles by this author , Wael KhoderWael Khoder More articles by this author , Christian G. StiefChristian G. Stief More articles by this author , Maximilian ReiserMaximilian Reiser More articles by this author , and Dirk-Andre ClevertDirk-Andre Clevert More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1981AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Over the last decades a rise in the incidence of malignant testicular tumours has been observed. In the diagnostic work-up of scrotal masses, B-mode sonography is a routine tool. Further information on microperfusion can be gained by using contrast-enhanced ultrasound (CEUS), which allows a more detailed assessment of microvessels compared to colour-coded Doppler sonography and thus permits a reliable distinction between vital and non-vital tissue. Recent elastography techniques provide measuring of shear-wave velocity operator-independently without application of manual pressure. Modern devices offer a colour-coded and numerical representation of tissue stiffness. The goal of this study was to evaluate the feasibility of the different techniques in the diagnostic work-up of unclear scrotal masses. METHODS This study has been accepted by the ethics committee of the Ludwig-Maximilians-University of Munich (Project-No. 161-12). Overall 20 male patients with scrotal masses were examined by B-mode sonography, colour-coded Doppler sonography, CEUS and elastography techniques using a Siemens Acuson S2000® or S3000® (Siemens Medical Solutions, Mountain View, CA, USA) ultrasound device. SonoVue® contrast agent (Bracco Imaging Deutschland, Konstanz, Germany) was used at the performance of contrast-enhanced ultrasound. If malignancy in the examined masses could not be ruled out an operative exploration followed, including an intraoperative frozen section analysis. RESULTS CEUS allowed a detailed assessment of microperfusion quality as well as a differentiation of the behaviour of contrasting (influx, flow-out of contrast agent), which was not possible using colour-coded Doppler sonography. Quantification of tissue elasticity using shear-wave elastography techniques showed statistically significant higher (p=0.002) mean stiffness in germ cell tumours (1.94 m/s) compared to normal testicular tissue (1.17 m/s) CONCLUSIONS Using CEUS in the diagnostic work-up of scrotal masses, a supplementary and highly sensitive tool for the imaging of testicular microperfusion is available. Different contrasting patterns permit a discrimination between malignant and benign testicular lesions. Innovative ARFI and ARFI-VTIQ shear-wave elastography techniques allow operator-independent quantification of tissue stiffness and are useful instruments in the assessment of scrotal masses and in the differentiation between regular testicular tissue and malignant lesions. These devices could contribute to improve therapy planning and may help to prevent unnecessary operative explorations in the future. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e38 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Julian Marcon More articles by this author Matthias Trottmann More articles by this author Melvin D'Anastasi More articles by this author Vera Mai More articles by this author Johannes Rübenthaler More articles by this author Wael Khoder More articles by this author Christian G. Stief More articles by this author Maximilian Reiser More articles by this author Dirk-Andre Clevert More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...