European Radiology

, Volume 25, Issue 2, pp 323–330 | Cite as

Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee

  • Jonathan Richenberg
  • Jane Belfield
  • Parvati Ramchandani
  • Laurence Rocher
  • Simon Freeman
  • Athina C. Tsili
  • Faye Cuthbert
  • Michal Studniarek
  • Michele Bertolotto
  • Ahmet Tuncay Turgut
  • Vikram Dogra
  • Lorenzo E. Derchi
Ultrasound
First Online:
Received:
Revised:
Accepted:

Abstract

Objectives

The subcommittee on scrotal imaging, appointed by the board of the European Society of Urogenital Radiology (ESUR), have produced guidelines on imaging and follow-up in testicular microlithiasis (TML).

Methods

The authors and a superintendent university librarian independently performed a computer-assisted literature search of medical databases: MEDLINE and EMBASE. A further parallel literature search was made for the genetic conditions Klinefelter’s syndrome and McCune-Albright syndrome.

Results

Proposed guidelines are: follow-up is not advised in patients with isolated TML in the absence of risk factors (see Key Points below); annual ultrasound (US) is advised for patients with risk factors, up to the age of 55; if TML is found with a testicular mass, urgent referral to a specialist centre is advised.

Conclusion

Consensus opinion of the scrotal subcommittee of the ESUR is that the presence of TML alone in the absence of other risk factors is not an indication for regular scrotal US, further US screening or biopsy. US is recommended in the follow-up of patients at risk, where risk factors other than microlithiasis are present. Risk factors are discussed and the literature and recommended guidelines are presented in this article.

Key Points

• Follow up advised only in patients with TML and additional risk factors.

• Annual US advised for patients with risk factors up to age 55.

• If TML is found with testicular mass, urgent specialist referral advised.

• Risk factors – personal/ family history of GCT, maldescent, orchidopexy, testicular atrophy.

Keywords

Testicular microlithiasis Testis microcalcification Germ cell tumour Ultrasound 
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Notes

Acknowledgments

The scientific guarantor of this publication is Jonathan Richenberg. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was not required because not applicable. Methodology: prospective/retrospective

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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Jonathan Richenberg
    • 1
  • Jane Belfield
    • 2
  • Parvati Ramchandani
    • 3
  • Laurence Rocher
    • 4
  • Simon Freeman
    • 5
  • Athina C. Tsili
    • 6
  • Faye Cuthbert
    • 7
  • Michal Studniarek
    • 8
  • Michele Bertolotto
    • 9
  • Ahmet Tuncay Turgut
    • 10
  • Vikram Dogra
    • 11
  • Lorenzo E. Derchi
    • 12
  1. 1.Royal Sussex County Hospital Brighton and Brighton and Sussex Medical SchoolBrightonUK
  2. 2.Royal Liverpool University HospitalLiverpoolUK
  3. 3.Perelman School of Medicine of the University of PennsylvaniaPhiladelphiaUSA
  4. 4.Hôpitaux Universitaires Paris Sud, APHP, site Bicêtre, Ecole doctorale BiosigneLe Kremlin BicêtreFrance
  5. 5.Plymouth Hospitals NHS TrustPlymouthUK
  6. 6.University of IoanninaIonninaGreece
  7. 7.Royal Sussex County HospitalBrightonUK
  8. 8.Medical University of GdanskGdanskPoland
  9. 9.Uco di Radiologia Dell ‘Universita’ di TriesteTriesteItaly
  10. 10.Department of RadiologyAnkara Training and Research HospitalAnkaraTurkey
  11. 11.Department of Imaging SciencesUniversity of Rochester School of Medicine and DentistryRochesterUSA
  12. 12.Universita di GenovaGenovaItaly

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