Diagnostic performance of contrast-enhanced ultrasound (CEUS) in testicular pathologies: Single-center results.

Background: Contrast-enhanced ultrasound (CEUS) has been used as an additional imaging technique in order to clarify testicular findings. CEUS is easy and fast to perform, overcomes the limitations of B-mode US.
Objective: To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the assessment of unclear testicular pathologies.
Methods: CEUS examinations of 45 patients with unclear testicular pathologies between 2012 and 2018 were analyzed retrospectively. Examinations were performed using B-mode, colour Doppler (CCDS) and CEUS after injection of contrast agent (SonoVue®, Bracco) and interpreted by an experienced radiologist (EFSUMB level 3). Reference standard was defined as histopathological report and clinical course.
Results: Overall 19 patients presented with a neoplastic lesion, whereas 14 were malignant. Matched to the histopathological report and clinical follow up, CEUS represented a sensitivity of 93% (95% -CI, 69-99), a specificity of 94% (95% -CI, 80-98), a positive predictive value (PPV) of 87% (95% -CI, 62-96) and a negative predictive value (NPV) of 97% (95% -CI, 83-99).
Conclusion: CEUS is an accurate additional tool to differentiate between testicular alterations when B-mode US and CCDS are uncertain. CEUS may provide additional information and detect early enhancement in small tumor lesions when CCDS comes to its limit.