RSNA 2014 

Abstract Archives of the RSNA, 2014


Evaluation of Intra and Extratesticular Lesions with Real TIme Elastography (RTE): Comparison of Strain Ratio (SR) versus Colour Map Visual Elasticity Score (VES)

Scientific Papers

Presented on December 5, 2014
Presented as part of SST07: Genitourinary (New Technology for Imaging the GU Tract)


Eleni Konstantatou MD, MSc, Presenter: Nothing to Disclose
Asif Iqbal MBBS, Abstract Co-Author: Nothing to Disclose
Cheng Fang MBBS, BSC, Abstract Co-Author: Nothing to Disclose
Paul Singh Sidhu MRCP, FRCR, Abstract Co-Author: Speaker, Bracco Group Speaker, Siemens AG Speaker, Hitachi, Ltd


The aim is to illustrate whether a correlation exists between the SR and the VES of the RTE colour map for testicular and extratesticular lesions and whether a statistical significant difference between SR calculated in benign versus malignant lesions occurs.


The scrotal lesions analyzed were retrieved from a departmental database of testicular sonographic investigations. All patients were examined by a single experienced operator in accordance to departmental protocol, employing standard techniques for RTE, using a linear 9MHz transducer Preirus, Hitachi Inc, Tokyo). The RTE images were retrospectively reviewed and the visual map was scored according to a grading scale (1-soft to 6-hard). The SR of the lesions stiffness was calculated at the time of scanning. Pearson’s correlation coefficient (PCC) was calculated. 


Over a 4-year period, 88 patients (median age 37.5y, range18-83y) underwent testicular sonographic evaluation for acute (n=21) and non-acute (n=67) conditions. There were intratesticular malignant lesions (n=25), benign intratesticular lesions (n=50) and benign extratesticular lesions (n=15) with size range 2-50mm. The diagnosis was confirmed with histology (n=51) or follow up (n=37) which showed resolution or stability of the lesion. The calculated mean SR for the benign lesions was 8.68 (range 0.37–89.92) and the mean VES was 4 (range1-6, ≤3 n=24 and >3 n=41). The mean SR for the malignant lesions was 13.74 (range 1.44-92.6) and the mean VER was 4.6 (range 1-6, ≤3 n=6 and >3 n=19). The strength of correlation between SR and colour map VER was summarized by PCC with the following values: for all lesions the r= 0.38; for malignant the r=0.40 and for benign lesions the r=0.36. All Pearson’s correlation coefficients proved to be statistically significant.


RTE is a useful adjuvant tool to B-Mode imaging of scrotal pathology, but it is not possible to stand alone with B-mode to improve diagnostic accuracy. There may be a need to add further techniques of parametric ultrasound imaging to the evaluation to improve the accuracy.


Elastography is a relatively new adjuvant sonographic technique which improves diagnostic accuracy, but it cannot stand alone in clinical practice.

Cite This Abstract

Konstantatou, E, Iqbal, A, Fang, C, Sidhu, P, Evaluation of Intra and Extratesticular Lesions with Real TIme Elastography (RTE): Comparison of Strain Ratio (SR) versus Colour Map Visual Elasticity Score (VES).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.