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Hu JY, Lin ZZ, Ding L, Zhang ZX, Huang WL, Huang SS, Li B, Xie XY, Lu MD, Deng CH, Lin HT, Gao Y, Wang Z. Prediction of testicular histology in azoospermia patients through deep learning-enabled two-dimensional grayscale ultrasound. Asian J Androl 2024:00129336-990000000-00252. [PMID: 39363830 DOI: 10.4103/aja202480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 08/01/2024] [Indexed: 10/05/2024] Open
Abstract
Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia. Therefore, we developed a deep learning (DL) model to establish the associations between testicular grayscale ultrasound images and testicular histology. We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia (353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China) to develop a DL model. We obtained testicular histology during conventional testicular sperm extraction. Our DL model was trained based on ultrasound images or fusion data (ultrasound images fused with the corresponding testicular volume) to distinguish spermatozoa presence in pathology (SPP) and spermatozoa absence in pathology (SAP) and to classify maturation arrest (MA) and Sertoli cell-only syndrome (SCOS) in patients with SAP. Areas under the receiver operating characteristic curve (AUCs), accuracy, sensitivity, and specificity were used to analyze model performance. DL based on images achieved an AUC of 0.922 (95% confidence interval [CI]: 0.908-0.935), a sensitivity of 80.9%, a specificity of 84.6%, and an accuracy of 83.5% in predicting SPP (including normal spermatogenesis and hypospermatogenesis) and SAP (including MA and SCOS). In the identification of SCOS and MA, DL on fusion data yielded better diagnostic performance with an AUC of 0.979 (95% CI: 0.969-0.989), a sensitivity of 89.7%, a specificity of 97.1%, and an accuracy of 92.1%. Our study provides a noninvasive method to predict testicular histology for patients with azoospermia, which would avoid unnecessary testicular biopsy.
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Affiliation(s)
- Jia-Ying Hu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Zhen-Zhe Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Li Ding
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Zhi-Xing Zhang
- Department of Ultrasonography, NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Human Sperm Bank of Guangdong Province, Guangzhou 510062, China
| | - Wan-Ling Huang
- Department of Medical Ultrasonics, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, China
| | - Sha-Sha Huang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Bin Li
- Clinical Trial Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao-Yan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Ming-De Lu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Chun-Hua Deng
- Department of Urology and Andrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Hao-Tian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Center for Precision Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Yong Gao
- Reproductive Medicine Center, The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Zhu Wang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
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Bole R, Kaiyal RS, Lundy SD, Nguyen JK, Parekh N, Vij SC. Discordant Bilateral Testicular Pathology Does not Affect Sperm Retrieval Rate in Bilateral Microdissection Testicular Sperm Extraction (mTESE). Urology 2023; 176:82-86. [PMID: 37054923 DOI: 10.1016/j.urology.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/13/2023] [Accepted: 03/29/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVE To assess the incidence of discordant testicular pathology in men undergoing bilateral microdissection testicular sperm extraction (mTESE) and association with sperm retrieval rate. METHODS We performed a retrospective single-institutional review of all patients undergoing mTESE from 2007 to 2021 and aggregated clinical history, physical exam, semen analysis, and operative findings. Specimens with discordant pathology were re-reviewed by an experienced genitourinary.ßpathologist and categorized in a standardized fashion. Data were analyzed using SPSS. RESULTS One hundred fourteen non-obstructive azoospermia.ßmen undergoing 132 mTESEs were identified within the study period. Eighty-five percent (112/132) of cases had pathology specimens available, and within this specific cohort the success rate was 41.9% (47/112). A total of 206 pathological reports resulted including 52.4% Sertoli cell only, 4.9% Leydig cell hyperplasia, 8.7% fibrosis, 16.5% maturation arrest, and 17.5% hypospermatogenesis. Twelve percent of testicles had more than 1 pathologic diagnosis. Sixty-six men had synchronous bilateral testicular pathology, and 11/66 (16.6%) had at least partially discordant pathology on initial review. Focused re-review by a genitourinary pathologist confirmed exclusively discordant pathology in 7/66 (10.6%) cases, with a sperm retrieval rate of 57% (4/7). The sperm retrieval rate.ßin men with discordant pathology was not significantly different from those with concordant pathology. CONCLUSION Over 1 in 10 men undergoing mTESE may have discordant pathology between testicles, though this may not affect sperm retrieval rate.ßat the time of procedure. Clinicians should consider submitting bilateral testicular specimens for pathology to (1) clarify their outcomes data, and (2) assist with clinical decision-making and surgical planning if a repeat mTESE is indicated.
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Affiliation(s)
- Raevti Bole
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Raneen Sawaid Kaiyal
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Scott D Lundy
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Jane K Nguyen
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Neel Parekh
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Sarah C Vij
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
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Sihag P, Tandon A, Pal R, Bhatt S, Sinha A, Sumbul M. Sonography in male infertility: a useful yet underutilized diagnostic tool. J Ultrasound 2022; 25:675-685. [PMID: 35038143 PMCID: PMC9402860 DOI: 10.1007/s40477-021-00646-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To assess the utility of comprehensive sonographic examination including scrotal sonography, Testicular Doppler and Transrectal Ultrasound (TRUS) to evaluate the male reproductive system and differentiate between obstructive (OG) and non-obstructive (NOG) causes of azoospermia. METHODS 30 infertile men with azoospermia and 30 control subjects with normospermia underwent sonographic evaluation. FNAC/biopsy findings were used for assigning a final diagnosis of obstructive or non-obstructive azoospermia. Qualitative and quantitative imaging parameters were retrospectively compared between the groups using Chi-square/Fisher's exact test and unpaired t-test, respectively. P < 0.05 was considered significant. RESULTS Ectasia of rete testis/epididymal tubules, altered epididymal echogenicity, dilated terminal vas deferens were significantly more common in OG while inhomogeneous testicular echo-texture and reduced testicular vascularity were more common in NOG (P < 0.05). Testicular volume and epididymal head size were significantly higher in OG than in NOG and controls (18.2 ml/10 mm Vs 8.2 ml/7.2 mm and 13.4 ml/8.8 mm respectively; P < 0.05); while Resistive Index (RI) of intra-testicular vessels was higher in NOG as compared to OG and controls (0.65 vs 0.54 and 0.52 respectively; P < 0.05). On ROC curve analysis, cut-off values of testicular volume (AUC: 0.939; P < 0.001), epididymal head size (AUC: 0.772; P = 0.001) and testicular RI (AUC: 0.761; P = 0.001) to differentiate between the groups were 12.1 ml (sensitivity-94.4%; specificity-83.3%), 9 mm (sensitivity-66.7%; specificity-71%) and 0.62 (sensitivity-62%; specificity-100%) respectively. CONCLUSION Comprehensive sonographic evaluation can be used to differentiate obstructive from non-obstructive infertility and should be routinely incorporated in the diagnostic workup of infertile men with azoospermia.
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Affiliation(s)
- Prateek Sihag
- Department of Radio-Diagnosis, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.
| | - Anupama Tandon
- Department of Radio-Diagnosis, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Raj Pal
- Department of Radio-Diagnosis, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Shuchi Bhatt
- Department of Radio-Diagnosis, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Arpita Sinha
- Department of Radio-Diagnosis, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Murtaza Sumbul
- Department of Radio-Diagnosis, University College of Medical Sciences and GTB Hospital, New Delhi, India
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De Santi B, Spaggiari G, Granata AR, Romeo M, Molinari F, Simoni M, Santi D. From subjective to objective: A pilot study on testicular radiomics analysis as a measure of gonadal function. Andrology 2021; 10:505-517. [PMID: 34817934 PMCID: PMC9299912 DOI: 10.1111/andr.13131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The connection between testicular ultrasound (US) parameters and testicular function, including both spermato- and steroidogenesis has been largely suggested, but their predictive properties are not routinely applied. Radiomics, a new engineering approach to radiological imaging, could overcome the visual limit of the sonographer. OBJECTIVES This study is aimed at extracting objective testicular US features, correlating with testicular function, including both spermato- and steroidogenesis, using an engineering approach, in order to overcome the operator-dependent subjectivity. MATERIALS AND METHODS Prospective observational pilot study from December 2019 to December 2020 on normozoospermic subjects and patients with semen variables alterations, excluding azoospermia. All patients underwent conventional semen analysis, pituitary-gonadal hormones assessment, and testicular US, performed by the same operator. US images were analyzed by Biolab (Turin) throughout image segmentation, image pre-processing, and texture features extraction. RESULTS One hundred seventy US testicular images were collected from 85 patients (age 38.6 ± 9.1 years). A total of 44 first-order and advanced features were extracted. US inhomogeneity defined by radiomics significantly correlates with the andrologist definition, showing for the first time a mathematical quantification of a subjective US evaluation. Thirteen US texture features correlated with semen parameters, predicting sperm concentration, total sperm number, progressive motility, total motility and morphology, and with gonadotropins serum levels, but not with total testosterone serum levels. Classification analyses confirmed that US textural features predicted patients' classification according to semen parameters alterations. CONCLUSIONS Radiomics texture features qualitatively describe the testicular parenchyma with objective and reliable quantitative parameters, reflecting both the testicular spermatogenic capability and the action of pituitary gonadotropins. This is an innovative model in which US texture features represent a mirror of the pituitary-gonadal homeostasis in terms of reproductive function.
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Affiliation(s)
- Bruno De Santi
- Biolab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Antonio Rm Granata
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Marilina Romeo
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Filippo Molinari
- Biolab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Pozza C, Kanakis G, Carlomagno F, Lemma A, Pofi R, Tenuta M, Minnetti M, Tarsitano MG, Sesti F, Paoli D, Anzuini A, Lenzi A, Isidori AM, Gianfrilli D. Testicular ultrasound score: A new proposal for a scoring system to predict testicular function. Andrology 2020; 8:1051-1063. [PMID: 32445591 PMCID: PMC7497152 DOI: 10.1111/andr.12822] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 12/18/2022]
Abstract
Background Testicular ultrasound (US) is routinely employed in the evaluation of reproductive and sexual function. However, its use for characteristics other than testicular volume is hampered by a lack of information on the prognostic value of its findings, which to date have only been incorporated in a score proposed by Lenz et al in 1993. Objectives We sought to explore whether testicular US examination can predict the quality of spermatogenesis and provide information on testicular endocrine function. Materials and methods We retrospectively reviewed 6210 testicular US examinations, finally selecting examinations from 2230 unique men. The following variables were considered: bitesticular volume and testicular asymmetry, parenchymal echotexture, echogenicity and presence of microlithiasis, solid lesions and varicocoele. Concurrent fasting hormonal data were available for 1160 men, while 979 had a semen sample available from the same day as the US examination. Results We derived a new US score, termed TU score, that can predict both impaired spermatogenesis (AUC 0.73, sensitivity 72%, specificity 61%, P < .001) and hypogonadism (AUC 0.71, sensitivity 71%, specificity 53%, P < .001) more accurately than the Lenz's score. In a multivariate analysis, a reduced sperm composite index (defined as total spermatozoa × total motility × normal forms) was independently predicted by bitesticular volume and by inhomogeneous echotexture, while hypogonadism was independently predicted also by reduced echogenicity and presence of microlithiasis. Discussion and conclusions We describe the testicular US characteristics that are independently associated with impaired spermatogenesis and hypogonadism and propose the TU score as a simple screening method for use in subjects referred for testicular US.
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Affiliation(s)
- Carlotta Pozza
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - George Kanakis
- Department of Endocrinology, Athens Naval & VA Hospital, Athens, Greece
| | | | - Andrea Lemma
- Department of Obstetrical and Gynaecological Sciences and Urological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Riccardo Pofi
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Marta Tenuta
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Marianna Minnetti
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Maria G Tarsitano
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Franz Sesti
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Donatella Paoli
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Antonella Anzuini
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
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First Evaluations and Cryopreservation of Semen Samples from Sunda Clouded Leopards ( Neofelis diardi). Animals (Basel) 2020; 10:ani10061072. [PMID: 32580372 PMCID: PMC7341292 DOI: 10.3390/ani10061072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The Sunda clouded leopard is a medium-sized cat from Borneo and Sumatra. The captive population has less than 20 individuals on both islands. Conservation breeding of this species has been unsuccessful due to the small numbers of individuals and the difficulty of pairing them. The present study aimed at evaluating for the first time the reproductive organs, semen characteristics, and sperm freezing for two wild-caught males (8 and 11 year old) living singly. The morphometric and ultrasound examination showed some degree of abnormalities in both leopards. Semen evaluation obtained by electro-ejaculation revealed a high proportion of abnormal sperm cells (similar to mainland clouded leopards). While only the younger male produced samples that could be frozen, post-thaw evaluations showed that the few surviving spermatozoa could potentially be used for in vitro fertilization or sperm injection. Studies on more individuals are needed to validate those encouraging but preliminary results. Abstract A better understanding of semen characteristics and resilience to freezing temperatures is necessary before developing assisted reproductive techniques and systematic biobanking for the Sunda clouded leopard. The objective of this study was to evaluate for the first time the semen and sperm quality (in fresh and frozen samples) of two captive Sunda clouded leopards in Malaysia. A total of 17 examinations of the reproductive tract (using ultrasonography) and electro-ejaculations were performed on the two leopards over a 2-year period. Samples obtained from Leopard 1 (8 years old) varied in terms of volume (402 ± 92 µL), pH (7.9 ± 0.9), sperm motility (54.5 ± 24.2%), sperm concentration (122.4 ± 84.7 × 106 sperm/mL), normal morphology (23.9 ± 12.3%), and viability (55.2 ± 18.2%). Midpiece defects represented the most common structural abnormality followed by abnormal tail and head defects. Samples from Leopard 2 (11 year old with abnormal testicular tissue) were of lesser quality. Two frozen semen samples from Leopard 1 were thawed and examined for acrosome integrity. Post-thawed samples contained <10% of motile spermatozoa but almost 50% of abnormal acrosomes. The present results emphasized the high incidence of structurally-abnormal spermatozoa, similar to the mainland clouded leopard. Post-thaw evaluations showed that the few surviving spermatozoa could potentially be used for in vitro fertilization or sperm injection. However, more individuals must be studied to validate those first findings that are exciting but still preliminary.
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Choi HI, Yang DM, Kim HC, Kim SW, Jeong HS, Moon SK, Lim JW. Testicular atrophy after mumps orchitis: ultrasonographic findings. Ultrasonography 2020; 39:266-271. [PMID: 32299198 PMCID: PMC7315290 DOI: 10.14366/usg.19097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/29/2020] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The purpose of this study was to describe the ultrasonographic findings of testicular atrophy after mumps orchitis. METHODS We retrospectively reviewed the case files of eight patients (14 to 24 years old; mean, 17 years) with mumps orchitis and testicular atrophy who were treated between January 2011 and September 2017. On gray-scale and color Doppler, the ultrasonographic features of volume, shape, echogenicity, and degree of blood flow in the testes were analyzed as part of both initial and follow-up ultrasonography. The duration between the initial diagnosis of mumps orchitis and the ultrasonographic diagnosis of testicular atrophy after mumps orchitis ranged from 25 to 230 days (mean, 95.9 days). RESULTS Of the eight patients with testicular atrophy after mumps orchitis, the testes were affected unilaterally in seven patients (6 right-sided and 1 left-sided) and bilaterally in one patient. The affected testes (n=9) were 23%-55% (mean, 44.7%) smaller in volume (mean, 6.3±2.0 mL) than the contralateral normal testes (n=7) (mean, 10.8±2.3 mL) on follow-up ultrasonography (P=0.001). The shape of the atrophic testes was oblong in seven cases and elliptical in two cases. The atrophic testes were either heterogeneously hypoechoic with multiple hyperechoic islands (n=7) or heterogeneously hyperechoic (n=2). On follow-up color Doppler ultrasonography, the degree of vascularity of the atrophic testis was either similar to (n=3) or lower than (n=6) that of the contralateral testis. CONCLUSION On ultrasonography, atrophic testes after mumps orchitis tended to exhibit an oblong shape, heterogeneous low echogenicity with multiple hyperechoic islands, and decreased vascularity.
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Affiliation(s)
- Hyeon-Il Choi
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Dal Mo Yang
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Hyun Cheol Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sang Won Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Hyun Seok Jeong
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sung Kyung Moon
- Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
| | - Joo Won Lim
- Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
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9
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Abstract
OBJECTIVE The purpose of this review is to evaluate the current role of percutaneous testicular biopsy in the diagnosis of focal testicular lesions. CONCLUSION Percutaneous testicular biopsy can be either fine needle aspiration biopsy or trucut core needle biopsy. It is a well-tolerated and effective procedure useful in small testicular lesions, multifocal lesions, hematological malignancies, and focal lesions in single testis.
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Affiliation(s)
- Subramaniyan Ramanathan
- Department of Radiology, Al-Wakra Hospital, Hamad Medical Corporation, PO Box 82228, Doha, Qatar.
- Department of Radiology, Weil Cornell Medical College, Doha, Qatar.
| | - Vikram Dogra
- Department of Imaging Science, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA
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Harlequin testicle and other uncommon pathologies masquerading at routine scrotal ultrasound. Ultrasound Q 2015; 31:109-16. [PMID: 25938549 DOI: 10.1097/ruq.0000000000000143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Many scrotal conditions manifest similarly as pain, swelling, a palpable abnormality, or a combination of these symptoms. Most common scrotal pathologies have characteristic accompanying sonographic findings. Less common pathologies can have similar clinical presentations, and imaging with scrotal ultrasound is required to aid in proper diagnosis. This article focuses on several of these less commonly encountered scrotal pathologies--including testicular segmental infarction, scrotal filariasis, scrotal mesothelioma, seminiferous tubule fibrosis, and scrotal leiomyosarcoma--and compares and contrasts them to more routine diagnoses. Familiarity with both typical and atypical scrotal conditions is necessary to make accurate diagnoses at ultrasound to guide appropriate treatment and avoid unnecessary surgery.
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Cokkinos DD, Antypa E, Tserotas P, Kratimenou E, Kyratzi E, Deligiannis I, Kachrimanis G, Piperopoulos PN. Emergency Ultrasound of the Scrotum: A Review of the Commonest Pathologic Conditions. Curr Probl Diagn Radiol 2011; 40:1-14. [DOI: 10.1067/j.cpradiol.2009.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
Similar to the experience of finding a lump upon physical examination of the breast, the detection of an intrascrotal mass is often a frightening experience for both the patient and his physician. Ultrasound is a nearly ideal modality for evaluation of the scrotum. This manuscript will review the sonographic assessment of the common pathologic and normal conditions that may present as a mass within the scrotum, including discussion of intratesticular and extratesticular etiologies.
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Patel MD, Patel BM. Sonographic and magnetic resonance imaging appearance of a burned-out testicular germ cell neoplasm. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:143-6. [PMID: 17182722 DOI: 10.7863/jum.2007.26.1.143] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Maitray D Patel
- Department of Radiology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
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Casalino DD, Kim R. Clinical importance of a unilateral striated pattern seen on sonography of the testicle. AJR Am J Roentgenol 2002; 178:927-30. [PMID: 11906874 DOI: 10.2214/ajr.178.4.1780927] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the clinical importance of a unilateral striated pattern seen on high-resolution sonography of a testicle on the basis of follow-up imaging. CONCLUSION In the absence of relevant clinical findings or an abnormal signal on color-flow or power Doppler sonography, a striated pattern of a testicle appears to have no clinical importance. It is presumed to represent fibrosis, and the patient most likely can be followed up clinically and sonographically rather than having to undergo surgical exploration.
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Affiliation(s)
- David D Casalino
- Department of Radiology, University of Chicago Hospitals, 5841 S. Maryland Ave., Chicago, IL 60637, USA
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Affiliation(s)
- P N Schlegel
- Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, USA
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