Ultrasound shear wave elastography in testicular cancer characterization

Multiparametric ultrasound evaluation of malignant testicular tumors was done in 31 patients (age ranged from 19 to 65 years (median - 33 years, 25-75^th percentiles - 27-40 years)). In all cases unilateral lesion took place. In all cases diagnosis was confirmed morphologically (seminoma - 18 (58.1%), embryonal carcinoma - 5 (16.1%), mixed germ cell tumors - 7 (22.6%), spermatocytic seminomas - 1 (3.2%)). In 13 (41.9%) cases were stages pT1, 15 (48.4%) -pT2, 3 (9.7%) -pT3. Shear wave elastography was used after preliminary gray-scale imaging of the testes (Aixplorer (Supersonic Imagine, France), linear probe 4-15 MHz). Emean median in the stiffest tumor areas (n = 31) was 109.3 kPa, 25-75^th percentiles - 77.7-145.5 kPa, 5-95^th percentiles - 18.7-192.4 kPa, minimum - maximum values - 15.3-241.4 kPa. The values of Young’s modulus (Emean) in the tumor region were significantly higher in compare to echographically intact parenchyma of the ipsilateral testis (1), contralateral testicular parenchyma (2) and normative data (3) (P < 0.0001 for all comparisons). Qualitative elastographic assessment (elastographic patterns) gives an idea of the tumor stiffness, however, depends on the chosen scale. At the moment, it is make sense to use qualitative assessment for the stiffest areas identification with following stiffness measurements. There was not found significant correlation between Young’s modulus and tumor volume, maximum linear tumor size, tumor stage, and morphological type. Direct significant correlation between the stiffness (elasticity) ratio (the ratio of Emean values in the stiffest tumor areas and echographically intact parenchyma of the ipsilateral testis) and pT stage (t_k = 0.32, P = 0.0305) was revealed. Elastometry, as a part of multiparametric testicular ultrasound, provides the new information about testicular tumors stiffness and can be used in the routine diagnosis because of low time-consuming.

мультипараметрическая ультразвуковая диагностика, ультразвуковая эластография, эластография сдвиговой волной, жесткость, модуль Юнга, скорость сдвиговой волны, рак яичка, multiparametric ultrasound, ultrasound elastography, shear wave elastography, stiffness, Young’s modulus, shear wave velocity, testicular cancer

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