Follow-up protocols for patients with testicular cancer (TC) have significantly reduced the number of cross-sectional imaging studies to reduce radiation exposure. At present, it is unclear whether magnetic resonance imaging (MRI) could replace conventional computerized tomography (CT) imaging. The objective of this study is to summarize the scientific evidence on this topic and to review guideline recommendations with regard to the use of MRI.
A systematic literature review was performed searching Medline and Cochrane databases for prospective studies on patients with TC in the follow-up care (last search in February 2021). Additionally, guideline recommendations for TC were screened. Data extraction and quality assessment of included studies were performed and used for a descriptive presentation of results.
A total of four studies including two ongoing trials were identified. Overall, the scientific evidence of prospective comparative studies is based on 102 patients. Data suggest that abdominal imaging with MRI can replace conventional CT for detection of lymph node metastasis of the retroperitoneum to spare radiation exposure and contrast media application. However, experienced radiologists are needed. Clinical guidelines are aware of the risk of diagnosis-induced secondary malignancy due to CT imaging and some have adapted their recommendations accordingly. Results of the two ongoing trials on 738 patients are expected soon to provide more reliable results on this topic.
There is growing evidence that abdominopelvic MRI imaging can replace CT imaging during follow-up of patients with TC in order to reduce radiation exposure and diagnosis-induced secondary malignancy.
World journal of urology. 2022 Jan 17 [Epub ahead of print]
Jonas Busch, Stefanie Schmidt, Peter Albers, Julia Heinzelbecker, Sabine Kliesch, Julia Lackner, David Pfister, Christian Ruf, Christian Winter, Friedemann Zengerling, Dirk Beyersdorff
Department of Urology, Charité Universitaetsmedizin Berlin, Berlin, Germany. ., UroEvidence@Deutsche Gesellschaft Für Urologie, Berlin, Germany., Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany., Department of Urology and Paediatric Urology, Saarland University Medical Centre and Saarland University Faculty of Medicine, Homburg, Saar, Germany., Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital, Münster, Münster, Germany., Department of Urology, University Hospital Cologne, Cologne, Germany., Department of Urology, Bundeswehrkrankenhaus (German Federal Armed Forces Hospital), Koblenz, Germany., Urologie Neandertal (Regional Joint Practice), Erkrath, Germany., Department of Urology, University Hospital Ulm, Ulm, Germany., Clinic and Polyclinic for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.