Imaging Recommendations for Diagnosis, Staging, and Management of Testicular Cancer

Abstract

The common testicular tumors affect young males in the third and fourth decades and germ cell tumors especially have excellent post-treatment outcomes. Hence, guidelines for clinical, radiological, and tumor marker assessment for diagnosis, response assessment, and surveillance of these tumors have critical impact on the management of these tumors. This article aims to discuss the current recommendations and guidelines regarding the clinical and radiological assessment and treatment pathways of testicular tumors.

Keywords

guidelines - imaging - recommendations - testicular cancer

• References

• 1 [World Cancer Research Fund. Worldwide Cancer Data: Global cancer statistics for the most common cancers. Accessed December 9, 2022, at: https://www.wcrf.org/dietandcancer/cancer-trends/worldwide-cancer-data] .
• 2 Znaor A, Lortet-Tieulent J, Jemal A, Bray F. International variations and trends in testicular cancer incidence and mortality. Eur Urol 2014; 65 (06) 1095-1106
• 3 Williamson SR, Delahunt B, Magi-Galluzzi C. et al; Members of the ISUP Testicular Tumour Panel. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology 2017; 70 (03) 335-346
• 4 Mittal PK, Abdalla AS, Chatterjee A. et al. Spectrum of extratesticular and testicular pathologic conditions at scrotal MR imaging. Radiographics 2018; 38 (03) 806-830
• 5 Makovník M, Rejleková K, Uhrin I, Mego M, Chovanec M. Intricacies of radiographic assessment in testicular germ cell tumors. Front Oncol 2021; 10: 587523 https://www.frontiersin.org/article/10.3389/fonc.2020.587523
• 6 Looijenga LHJ, Van der Kwast TH, Grignon D. et al. Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers: IV: current and future utilization of molecular-genetic tests for testicular germ cell tumors. Am J Surg Pathol 2020; 44 (07) e66-e79
• 7 Oosterhuis JW, Looijenga LHJ. Testicular germ-cell tumours in a broader perspective. Nat Rev Cancer 2005; 5 (03) 210-222
• 8 Hale GR, Teplitsky S, Truong H, Gold SA, Bloom JB, Agarwal PK. Lymph node imaging in testicular cancer. Transl Androl Urol 2018; 7 (05) 864-874
• 9 Magers MJ, Idrees MT. Updates in staging and reporting of testicular cancer. Surg Pathol Clin 2018; 11 (04) 813-824
• 10 International Germ Cell Cancer Collaborative Group. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997; 15 (02) 594-603
• 11 Laguna M. et al. EAU guidelines on testicular cancer 2022. Accessed December 9, 2022, at : http://www.uroweb.org/guideline/testicularcancer/
• 12 Lobo J, Leão R, Gillis AJM. et al. Utility of Serum miR-371a-3p in predicting relapse on surveillance in patients with clinical stage I testicular germ cell cancer. Eur Urol Oncol 2021; 4 (03) 483-491
• 13 Wilson SR, Greenbaum LD, Goldberg BB. Contrast-enhanced ultrasound: what is the evidence and what are the obstacles?. AJR Am J Roentgenol 2009; 193 (01) 55-60
• 14 Coursey Moreno C, Small WC, Camacho JC. et al. Testicular tumors: what radiologists need to know–differential diagnosis, staging, and management. Radiographics 2015; 35 (02) 400-415
• 15 Winter TC, Kim B, Lowrance WT, Middleton WD. Testicular microlithiasis: what should you recommend?. AJR Am J Roentgenol 2016; 206 (06) 1164-1169
• 16 Lock G, Schmidt C, Helmich F, Stolle E, Dieckmann KP. Early experience with contrast-enhanced ultrasound in the diagnosis of testicular masses: a feasibility study. Urology 2011; 77 (05) 1049-1053
• 17 Aigner F, De Zordo T, Pallwein-Prettner L. et al. Real-time sonoelastography for the evaluation of testicular lesions. Radiology 2012; 263 (02) 584-589
• 18 Feldman DR, Lorch A, Kramar A. et al. Brain metastases in patients with germ cell tumors: Prognostic factors and treatment options - an analysis from the Global Germ Cell Cancer Group. J Clin Oncol 2016; 34 (04) 345-351
• 19 National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Testicular Cancer. Version 1.2019. October 22, 2018. Accessed December 9, 2022, at : https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf
• 20 Necchi A, Nicolai N, Alessi A. et al. Interim 18F-Fluorodeoxyglucose Positron Emission Tomography for Early Metabolic Assessment of Response to Cisplatin, Etoposide, and Bleomycin Chemotherapy for Metastatic Seminoma: Clinical Value and Future Directions. In: Clinical Genitourinary Cancer. Vol 14.; 2016.
• 21 Honecker F, Aparicio J, Berney D. et al. ESMO consensus conference on testicular germ cell cancer: diagnosis, treatment and follow-up. In: Annals of Oncology. Vol 29.; 2018.
• 22 Bachner M, Loriot Y, Gross-Goupil M. et al. 2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) for postchemotherapy seminoma residual lesions: a retrospective validation of the SEMPET trial. Ann Oncol 2012; 23 (01) 59-64
• 23 Cathomas R, Klingbiel D, Bernard B. et al. Questioning the value of fluorodeoxyglucose positron emission tomography for residual lesions after chemotherapy for metastatic seminoma: results of an International Global Germ Cell Cancer Group Registry. J Clin Oncol 2018; 36 (34) JCO1800210
• 24 Murthy V, Karmakar S, Carlton J. et al. Radiotherapy for post-chemotherapy residual mass in advanced seminoma: a fluorodeoxyglucose positron emission tomography-computed tomography-based risk-adapted approach. Clin Oncol (R Coll Radiol) 2021; 33 (07) e315-e321
• 25 Oechsle K, Hartmann M, Brenner W. et al; German Multicenter Positron Emission Tomography Study Group. [18F]Fluorodeoxyglucose positron emission tomography in nonseminomatous germ cell tumors after chemotherapy: the German multicenter positron emission tomography study group. J Clin Oncol 2008; 26 (36) 5930-5935
• 26 Ilic D, Misso ML. Screening for testicular cancer. Cochrane Database Syst Rev 2011; (02) CD007853
• 27 Gilbert K, Nangia AK, Dupree JM, Smith JF, Mehta A. Fertility preservation for men with testicular cancer: is sperm cryopreservation cost effective in the era of assisted reproductive technology?. Urol Oncol 2018; 36 (03) 92.e1-92 .e9
• 28 Brierley JE. et al. The TNM Classification of Malignant Tumours 8th edition. 2016. Accessed December 9, 2022, at: https://www.uicc.org/resources/tnm-classification-malignant-tumours-8th-edition