MRI in the Follow-up of Testicular Cancer: Less is More

Abstract

Background/aim: This study aimed to report the location of abdominal relapse in patients with testicular cancer.

Materials and methods: This is a retrospective cross-sectional study including patients who underwent abdominal magnetic resonance imaging (MRI) after treatment of testicular germ cell cancer. MRI reports were classified as negative or positive, and positive results were cross-checked with follow-up imaging and biopsy results. Positive histology or cytology defined a true-positive finding. The location of relapse was registered according to the anatomical site.

Results: In a 2-year period, 2,315 MRI examinations were performed. Relapse was detected in 0.7% (95% CI=0.4-1.1) of the examinations. Among these, 75% were seminomas and 25% were non-seminomas. Retroperitoneal lymph nodes were affected in 88% of cases, and pelvic and inguinal lymph nodes affected in 12% of cases. No metastases were found in parenchymatous organs or bony structures.

Conclusion: All cases of abdominal relapse occurred in retroperitoneal or pelvic lymph nodes. This suggests that MRI should be directed towards the retroperitoneum and pelvis only.

Keywords: MRI; lymph node; metastases; non-seminoma; relapse; seminoma; testicular cancer.