MRI of the scrotum: Recommendations of the ESUR Scrotal and Penile Imaging Working Group

The Scrotal and Penile Imaging Working Group (SPI-WG) appointed by the board of the European Society of Urogenital Radiology (ESUR) has produced recommendations for magnetic resonance imaging (MRI) of the scrotum.

The SPI-WG searched for original and review articles published before September 2016 using the Pubmed and Medline databases. Keywords used were 'magnetic resonance imaging', 'testis or testicle or testicular', 'scrotum', 'intratesticular', 'paratesticular', 'extratesticular' 'diffusion-weighted', 'dynamic MRI'. Consensus was obtained among the members of the subcommittee. The expert panel proposed recommendations using Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.

The recommended MRI protocol should include T1-, T2-weighted imaging, diffusion-weighted imaging and dynamic contrast-enhanced MRI. Scrotal MRI can be clinically applied for lesion characterisation (primary), including both intratesticular and paratesticular masses, differentiation between germ-cell and non-germ-cell neoplasms (evolving), characterisation of the histological type of testicular germ cell neoplasms (TGCNs, in selected cases), local staging of TGCNs (primary), acute scrotum (in selected cases), trauma (in selected cases) and undescended testes (primary).

The ESUR SPI-WG produced this consensus paper in which the existing literature on MRI of the scrotum is reviewed. The recommendations for the optimal imaging technique and clinical indications are presented.

• This report presents recommendations for magnetic resonance imaging (MRI) of the scrotum. • Imaging acquisition protocols and clinical indications are provided. • MRI is becoming established as a worthwhile second-line diagnostic tool for scrotal pathology.

European radiology. 2017 Jul 11 [Epub ahead of print]

Athina C Tsili, Michele Bertolotto, Ahmet Tuncay Turgut, Vikram Dogra, Simon Freeman, Laurence Rocher, Jane Belfield, Michal Studniarek, Alexandra Ntorkou, Lorenzo E Derchi, Raymond Oyen, Parvati Ramchandani, Mustafa Secil, Jonathan Richenberg

Department of Clinical Radiology, Medical School, University of Ioannina, University Campus, 45110, Ioannina, Greece. ., Uco di Radiologia Dell 'Universita' di Trieste, Strada di Fiume 447, Trieste, Italy., Department of Radiology, Ankara Training and Research Hospital, 06590, Ankara, Turkey., Department of Imaging Sciences, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 648, Rochester, NY, USA., Plymouth Hospitals NHS Trust, Plymouth, UK., APHP, site Bicêtre, Ecole doctorale Biosigne, Hôpitaux Universitaires Paris Sud, ED 419, 78 Avenue du General Leclerc, 94270, Le Kremlin Bicêtre, France., Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK., Medical University of Gdansk, ul Debinki 7, Gdansk, Poland., Department of Clinical Radiology, Medical School, University of Ioannina, University Campus, 45110, Ioannina, Greece., Universita di Genova, Largo R. Benzi, 8, Genova, Italy., Radiology, UZ Herestraat 49, box 7003 54 3000, Leuven, Belgium., Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA., Department of Radiology, Dokuz Eylul University Faculty of Medicine, Inciralti, Izmir, Turkey., Royal Sussex County Hospital Brighton and Brighton and Sussex Medical School, Brighton, Sussex, UK.