Jonas Busch1,2, Stefanie Schmidt3, Peter Albers4, Julia Heinzelbecker5, Sabine Kliesch6, Julia Lackner3, David Pfister7, Christian Ruf8, Christian Winter9, Friedemann Zengerling10, Dirk Beyersdorff11. 1. Department of Urology, Charité Universitaetsmedizin Berlin, Berlin, Germany. Jonas.busch@vivantes.de. 2. Department of Urology, Vivantes Klinikum Am Urban, Dieffenbachstr. 1, 10967, Berlin, Germany. Jonas.busch@vivantes.de. 3. UroEvidence@Deutsche Gesellschaft Für Urologie, Berlin, Germany. 4. Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany. 5. Department of Urology and Paediatric Urology, Saarland University Medical Centre and Saarland University Faculty of Medicine, Homburg, Saar, Germany. 6. Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital, Münster, Münster, Germany. 7. Department of Urology, University Hospital Cologne, Cologne, Germany. 8. Department of Urology, Bundeswehrkrankenhaus (German Federal Armed Forces Hospital), Koblenz, Germany. 9. Urologie Neandertal (Regional Joint Practice), Erkrath, Germany. 10. Department of Urology, University Hospital Ulm, Ulm, Germany. 11. Clinic and Polyclinic for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Abstract
PURPOSE: 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. METHODS: 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. 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. CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. 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. CONCLUSIONS: 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.
Authors: Axel Heidenreich; Peter Albers; Johannes Classen; Markus Graefen; Jürgen Gschwend; Jörg Kotzerke; Susanne Krege; Jens Lehmann; Detlef Rohde; Heinz Schmidberger; Michael Uder; Hajo Zeeb Journal: Urol Int Date: 2010-07-26 Impact factor: 2.089
Authors: Sabine Kliesch; Stefanie Schmidt; Doris Wilborn; Clemens Aigner; Walter Albrecht; Jens Bedke; Matthias Beintker; Dirk Beyersdorff; Carsten Bokemeyer; Jonas Busch; Johannes Classen; Maike de Wit; Klaus-Peter Dieckmann; Thorsten Diemer; Anette Dieing; Matthias Gockel; Bernt Göckel-Beining; Oliver W Hakenberg; Axel Heidenreich; Julia Heinzelbecker; Kathleen Herkommer; Thomas Hermanns; Sascha Kaufmann; Marko Kornmann; Jörg Kotzerke; Susanne Krege; Glen Kristiansen; Anja Lorch; Arndt-Christian Müller; Karin Oechsle; Timur Ohloff; Christoph Oing; Ulrich Otto; David Pfister; Renate Pichler; Heinrich Recken; Oliver Rick; Yvonne Rudolph; Christian Ruf; Joachim Schirren; Hans Schmelz; Heinz Schmidberger; Mark Schrader; Stefan Schweyer; Stefanie Seeling; Rainer Souchon; Christian Winter; Christian Wittekind; Friedemann Zengerling; D H Zermann; Roger Zillmann; Peter Albers Journal: Urol Int Date: 2021-01-22 Impact factor: 2.089
Authors: Sandeep S Hedgire; Vivek K Pargaonkar; Azadeh Elmi; Alpana M Harisinghani; Mukesh G Harisinghani Journal: Radiol Clin North Am Date: 2012-10-11 Impact factor: 2.303
Authors: Richard Cathomas; Michael Hartmann; Susanne Krege; Rainer Souchon; Anja Lorch; Frank Mayer; Maria De Santis; Silke Gillessen Journal: Onkologie Date: 2011-01-17
Authors: Timothy Gilligan; Daniel W Lin; Rahul Aggarwal; David Chism; Nicholas Cost; Ithaar H Derweesh; Hamid Emamekhoo; Darren R Feldman; Daniel M Geynisman; Steven L Hancock; Chad LaGrange; Ellis G Levine; Thomas Longo; Will Lowrance; Bradley McGregor; Paul Monk; Joel Picus; Phillip Pierorazio; Soroush Rais-Bahrami; Philip Saylor; Kanishka Sircar; David C Smith; Katherine Tzou; Daniel Vaena; David Vaughn; Kosj Yamoah; Jonathan Yamzon; Alyse Johnson-Chilla; Jennifer Keller; Lenora A Pluchino Journal: J Natl Compr Canc Netw Date: 2019-12 Impact factor: 11.908