Shear-wave elastography in the assessment of testicular hematologic malignancy in children and young adults: a feasibility study
Seok Young Koh, Seunghyun Lee , Seul Bi Lee, Yeon Jin Cho, Young Hun Choi, Jung-Eun Cheon, Woo Sun Kim
Seoul National University Hospital, SEOUL, Korea
Corresponding Author: Seunghyun Lee ,Tel: 821034259259, Fax: 827475781, Email: seunghyun.lee.22@gmail.com
Received: March 26, 2021;  Accepted: September 6, 2021.  Published online: September 6, 2021.
ABSTRACT
Purpose:
This study aimed to assess the feasibility of shear-wave elastography (SWE) in testicular hematologic malignancy in children and young adults. Materials and
Methods:
A total of eight patients (mean age, 11.0 years; range, 0.8–20 years) with biopsy confirmed testicular hematologic malignancy between January 2018 and December 2020 were retrospectively evaluated. Multiparametric ultrasound examinations, including grayscale, color Doppler ultrasound (CDUS), and SWE, were performed. The stiffness was measured on the involved testicular area and contralateral normal parenchyma and if there was bilateral testicular involvement, the stiffness of involved area and adjacent normal echoic parenchyma was measured on one-sided testis. The Mann-Whitney U test was used for comparison of the stiffness.
Results:
On grayscale, the testicular lesions were noted as a solitary mass in one patient, multiple lesions in four patients, and diffuse involvement in three patients. On CDUS and SWE, all patients demonstrated increased vascularity, and the stiffness of the involved area was higher than the values of normal parenchyma (the involved area vs. normal parenchyma, 11.6 kPa [3.9–20.2 kPa] vs. 2.9 kPa [1.1–3.7 kPa], p= 0.003). The ratio of stiffness between the involved area and normal parenchyma was 3.4, ranging from 1.9 to 5.1. One patient showed decreased stiffness on follow-up SWE after treatment (initial; 7.0 mm3 vs. 1.0 mm3, 1 year later; 3.2 mm3 vs. 2.1 mm3, affected testis vs. normal testis).
Conclusion:
The increased testicular stiffness on SWE in children and young adults with hematologic malignancy suggests the possibility of testicular involvement.
Keywords: Testis; Leukemia; Ultrasonography; Elastography; Child
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