Usefulness of apparent diffusion coefficient values and magnetic resonance imaging histogram analysis for identifying histological types of preoperative testicular tumors

Abstract

This study aimed to evaluate the ability of magnetic resonance imaging (MRI), including diffusion-weighted imaging with apparent diffusion coefficient values, to differentiate histological types of testicular tumors. Of 156 testicular tumors diagnosed at our hospital between January 2010 and July 2023, 65 cases with MRI were included. Tumors were categorized as seminoma, non-seminoma, and malignant lymphoma. Apparent diffusion coefficient values were calculated and analyzed using the ratio to normal testes and histograms according to tumor subtypes. Among the 65 cases, 46 were seminomas, 14 non-seminomas, and 5 malignant lymphomas. The apparent diffusion coefficient value ratio of seminomas was significantly higher than that of malignant lymphomas (p = 0.013). Additionally, the apparent diffusion coefficient value ratio of non-seminomas was significantly higher than that of seminomas and malignant lymphomas (p = 0.0013 and p < 0.001, respectively). On apparent diffusion coefficient histograms, malignant lymphomas had significantly higher values of kurtosis and skewness than seminomas. Normal testes and non-seminomas had significantly higher kurtosis and skewness values than that of malignant lymphomas and seminomas. A scoring model for seminomas and malignant lymphomas, developed with age and apparent diffusion coefficient value ratios, discriminated against the probability of seminoma and malignant lymphomas. MRI using apparent diffusion coefficient values and histogram analysis may aid the histological typing of seminomas, non-seminomas, malignant lymphomas.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

the Bioethics Committee Dokkyo Medical University Saitama Medical Center

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All relevant data are within the manuscript and its Supporting Information files.

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