The Scrotal and Penile Imaging Working Group (SPIWG) of the European Society of Urogenital Radiology (ESUR) aimed to formulate recommendations on the imaging modalities and minimal technical requirements for abdominopelvic imaging in the follow-up of adult patients treated for testicular germ-cell tumors (TGCT).
The SPIWG members performed an extensive literature search, reviewed the current clinical practice, and reached a consensus based on the opinions of experts in the field.
Recurrence in patients treated for TGCT mainly occurs in retroperitoneal lymph nodes (LNs). Abdominopelvic CT and MRI are equivalent assessing retroperitoneal LNs. MRI has the advantage of avoiding radiation exposure, and moreover, diffusion-weighted images (DWI) may increase the detection rates without the need for contrast administration. In patients treated for stage I TGCT, the ESUR-SPIWG recommends MRI over CT for the detection of retroperitoneal LNs during the follow-up after treatment. CT, however, remains the follow-up imaging of choice in patients with advanced disease. When MRI is used, the recommended minimal requirements are at least one high-quality anatomical sequence (T1-WI or T2-WI) in axial and coronal planes, and DWI in the same axial plane, ≤ 4 mm contiguous slices from the diaphragm to the perineum. When CT is used, the recommended minimal requirement is a standard-dose contrast-enhanced CT in the portal-venous phase, scanned from the diaphragm to the perineum.
In this paper, the ESUR-SPIWG provides recommendations on the imaging modalities and minimal technical requirements for abdominopelvic imaging in the follow-up of adult patients treated for TGCT.
Question There are no recommendations on the preferred imaging modality or scan sequences required for abdominopelvic imaging in the follow-up after treatment for testicular cancers. Findings The European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group (ESUR-SPIWG) provides recommendations for abdominopelvic imaging in follow-up after treatment for testicular cancers. Clinical relevance Recurrence of testicular germ-cell tumors mainly occurs in retroperitoneal lymph nodes. Both CT and MRI provide similar morphological assessments, but radiation exposure can be avoided by using MRI instead of CT.
European radiology. 2025 Jan 25 [Epub ahead of print]
Pieter De Visschere, Michele Bertolotto, Jane Belfield, Irene Campo, Beniamino Corcioni, Lorenzo Derchi, Vikram Dogra, Caterina Gaudiano, Dean Y Huang, Oliwia Kozak, Francesco Lotti, Karolina Markiet, Olivera Nikolic, Nicola Pavan, Vassiliki Pasoglou, Subramaniyan Ramanathan, Jonathan Richenberg, Laurence Rocher, Camilla Sachs, Paul S Sidhu, Katarzyna Skrobisz, Michal Studniarek, Athina Tsili, Mustafa Secil
Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium. ., Department of Radiology, University of Trieste, Ospedale di Cattinara, Trieste, Italy., Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK., Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Department of Radiology, Università degli Studi di Genova, Genoa, Italy., Department of Radiology, University of Rochester, Rochester, New York, USA., Department of Imaging Sciences, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK., Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland., Andrology, Female Endocrinology and Gender Incongruence Unit, University Hospital Careggi (AOUC), Florence, Italy., Center for Radiology, University Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia., Urology Clinic, Department of Precision Medicine in Medical, Surgical and Critical Care, University of Palermo, Palermo, Italy., Department of Radiology, Cliniques universitaires Saint Luc, Brussels, Belgium., Department of Radiology, AI Wakra Hospital, Hamad Medical Corporation, Weill Cornell Medicine, Doha, Qatar., Department of Imaging, Brighton and Sussex University Hospitals NHS Trust and Brighton and Sussex Medical School, Brighton, UK., Service de Radiologie, Hôpital Antoine Béclère, APHP, BIOMAPS. UMR1281. Université Paris Saclay, Le Kremlin-Bicêtre, Paris, UK., Radiological Department, General Hospital Treviso, Treviso, Italy., Department of Clinical Radiology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece., Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.