Improved diagnostic confidence using Super Resolution CEUS imaging in testicular lesions

Issue title: Selected articles of the 42th Conference of the German Society for Clinical Microcirculation and Hemorheology, 15–16 November 2024, Senftenberg, Germany

Guest editors: S. Braune and F. Jung

Article type: Research Article

Authors: Apfelbeck, Maria^a | Loupas, Thanasis^b | Chaloupka, Michael^a | Clevert, Dirk-André^{c; d; *}

Affiliations: [a] Department of Urology, LMU Klinikum, Munich, Germany | [b] Fellow Scientist, Philips Ultrasound R&D, Seattle, WA, USA | [c] Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany | [d] Interdisciplinary Ultrasound-Center, Ludwig-Maximilians-University Munich, Munich, Germany

Correspondence: [*] Corresponding author: Dirk-André Clevert, MD, Department of Radiology, Interdisciplinary Ultrasound-Center, Ludwig-Maximilians-University, Munich, Marchioninistrasse 15, 81377 Munich, Germany. E-mail: [email protected].

Abstract: Ultrasound is the most used interdisciplinary non-ionizing imaging technique in clinical pathologies of the testis. The testis may be affected by a plethora of different disorders such as vasculopathies, trauma, infections and manifestations of primary and secondary malignant masses. Conventional ultrasound represents the basic imaging modality of choice to assess scrotal disorders. Contrast-enhanced ultrasound (CEUS) can provide further information to distinguish between benign and malignant testicular mass lesions. The recent introduction of Super Resolution CEUS Micro-Vascular Imaging (MVI SR) and Time of Arrival (TOA SR) parametric mapping compliments the information provided by conventional CEUS, since these two new post-processing techniques improve the visualization of microvascular structures with slow blood flow and provide high-resolution images of the peak contrast enhancement and temporal perfusion patterns. This paper gives a comprehensive overview of differential diagnoses of the testicular disorder and their corresponding sono-morphologic correlates based on representative cases of the Interdisciplinary Ultrasound Center of the University Hospital Munich.

Keywords: Super Resolution CEUS imaging, Micro Vascular Imaging, Time of Arrival, seminoma, teratoma, Leydig cell tumor, abscess, ultrasound

DOI: 10.3233/CH-248109

Journal: Clinical Hemorheology and Microcirculation, vol. 88, no. s1, pp. S113-S125, 2024