Laurence Marie Rocher MD, Presenter: Nothing to Disclose

Vincent Izard, Abstract Co-Author: Nothing to Disclose

Mickael Tanter PhD, Abstract Co-Author: Co-founder, SuperSonic Imagine

Jean Luc Gennisson MD, PhD, Abstract Co-Author: Consultant, SuperSonic Imagine

Aline Criton, Abstract Co-Author: Employee, SuperSonic Imagine

Marie-France Bellin MD, Abstract Co-Author: Nothing to Disclose

Jean-Michel Correas MD, Abstract Co-Author: Advisory Board, Koninklijke Philips NV Speaker, Bracco Group Investigator, Bracco Group Speaker, SuperSonic Imagine Speaker, General Electric Company

To establish normal testis shear wave elastography (SWE) findings, including artifacts and limits and to illustrate the several patterns and elasticity values found in the case of testis tumors, infertility and varicocele.

200 patients referred for a testis ultrasound examination were studied using B-mode harmonic imaging, color-Doppler US (CDUS) and dynamic SWE using the Aixplorer plateform (Supersonic Imaging, Aix-en-Provence, France) with a high-frequency linear transducer (SL15-4 MHz). For each patient and testis, the following data were collected: - testis volume, echogenicity, presence of varicocele (with and without valsalva maneuver), stiffness with 3 quantitative measurements using a Region-of-Interest (ROI; in kPa) - in the presence of a mass: size, echogenicity, vascularity and the highest stiffness value measured in the lesion. A Student’s t-test was performed to compare each pathological group; p < 0.05 was considered to represent a statistically significant difference.  

In the normal population, the color coding inside the SWE ROI was homogeneous using a scale of 30 kPa. The normal testis stiffness was very low: 2.4±0.5 kPa. The periphery of the gland and the hilum exhibited higher stiffness values. In the case of lesions, the mean ± SD stiffness values were for: malignant tumors (n= 7) 61.6±46.7 kPa); burned out tumors (n=4) 18±8.7 kPa; benign proved tumors (n=2) and nodules with benign features and follow-up period over 1 year (n=6) 4.1±1.9 kPa; infertility and severe testis hypotrophy (n= 40, testis volume <10 mL) 2.2±0.94 kPa; obstructive status (n=7) 2.4±0.43 kPa; varicocele (n=30) 2.4±0.6 kPa and 2.3±0,6 kPa with and without Valsalva manoeuver respectively. No statistically significant difference was found  between varicocele and normal testis.. Stiffness values were significantly higher in malignant tumors and burn-out tumors compared to that of normal testis stiffness (p=0.026 and p=0.018 respectively) and benign tumors (p=0.030 and p=0.024 respectively). Limitations included stiffness assessment in cryptorchidism.  

SWE of the testis is a novel imaging technique that can be used for stiffness measurement. Despite the limited number of benign and malignat lesions, a statistically significant difference was found between these populations

SWE will be helpful to discriminate benign from malignant  testis tumors.

Rocher, L, Izard, V, Tanter, M, Gennisson, J, Criton, A, Bellin, M, Correas, J, Testis Shear Wave Elastography: Preliminary Experience Based on 200 Patients Testis Shear Wave Elastography: Preliminary Experience Based on 200 Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013197.html