{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:26:01Z","timestamp":1787757961586,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n The purpose of this study was to evaluate the diagnostic performance of multiparametric ultrasound (mpUS; grayscale US, color Doppler US, strain elastography, and contrast-enhanced US) in the assessment of testicular lesions with negative tumoral markers. MpUS imaging data, patient age, serum tumor markers, scrotal pain, cryptorchidism, and related clinical information were retrospectively collected for patients who underwent mpUS examination between January 2013 and December 2019. Histologic results or follow-up examinations were used as the reference standard. In total, 83 lesions from 79 patients were included in the analysis. Fifty-six patients were finally diagnosed with benign tumors, and 23 patients were ultimately diagnosed with malignant tumors. Chi-square tests or Fisher\u2019s exact tests were used to assess the difference between the two groups. Stepwise multivariate logistic regression analysis showed that lesion diameter (odds ratio [OR] = 1.072,\n P<\/jats:italic>\n = 0.005), vascularization on color Doppler US (OR = 4.066,\n P<\/jats:italic>\n = 0.001), and hyperenhancement during the early phase (OR = 6.465,\n P<\/jats:italic>\n = 0.047) were significant independent risk factors for malignancy; however, when compared with neoplastic lesions, pain (OR = 0.136,\n P<\/jats:italic>\n < 0.001), absence of vascularization on color Doppler US (OR = 1.680,\n P<\/jats:italic>\n = 0.042), and nonenhancement during the late phase (OR = 3.461,\n P<\/jats:italic>\n = 0.031) were strongly associated with nonneoplastic lesions. MpUS features are useful for differentiating testicular lesions with negative tumoral markers and improving the preoperative diagnosis, which may avoid inappropriate radical orchiectomy.\n <\/jats:p>","DOI":"10.4103\/aja202235","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T05:01:26Z","timestamp":1654837286000},"page":"50-57","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Multiparametric ultrasound for the assessment of testicular lesions with negative tumoral markers"],"prefix":"10.4103","volume":"25","author":[{"given":"Hui","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Hua","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Si","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ping","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumor, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai 200072, China"},{"name":"Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China"},{"name":"National Clinical Research Center for Interventional Medicine, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Xiong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Zhongshan Hospital, Fudan University, Institute of Ultrasound in Medicine and Engineering, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1]]},"reference":[{"key":"R1-20240829","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1148\/rg.352140097","article-title":"Testicular tumors: what radiologists need to know-differential diagnosis, staging, and management","volume":"35","author":"Coursey Moreno","year":"2015","journal-title":"Radiographics"},{"key":"R2-20240829","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.2214\/AJR.12.10319","article-title":"Testicular cancer: what the radiologist needs to know","volume":"200","author":"Kreydin","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"R3-20240829","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.eururo.2010.01.014","article-title":"Organ-sparing surgery for adult testicular tumours: a systematic review of the literature","volume":"57","author":"Giannarini","year":"2010","journal-title":"Eur Urol"},{"key":"R4-20240829","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/S0022-5347(01)61781-6","article-title":"Semen quality and reproductive hormones before and after orchiectomy in men with testicular cancer","volume":"161","author":"Petersen","year":"1999","journal-title":"J Urol"},{"key":"R5-20240829","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.clgc.2017.01.012","article-title":"Reliability of frozen section examination in a large cohort of testicular masses: what did we learn?","volume":"15","author":"Matei","year":"2017","journal-title":"Clin Genitourin Cancer"},{"key":"R6-20240829","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/S0302-2838(02)00004-0","article-title":"Accuracy of frozen section examination of testicular tumors of uncertain origin","volume":"41","author":"Elert","year":"2002","journal-title":"Eur Urol"},{"key":"R7-20240829","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1148\/radiol.2271001744","article-title":"Sonography of the scrotum","volume":"227","author":"Dogra","year":"2003","journal-title":"Radiology"},{"key":"R8-20240829","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00117-013-2575-5","article-title":"Elastography as an additional tool in breast sonography. Technical principles and clinical applications","volume":"54","author":"Rjosk-Dendorfer","year":"2014","journal-title":"Radiologe"},{"key":"R9-20240829","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1055\/a-0586-1107","article-title":"The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (long version)","volume":"39","author":"Sidhu","year":"2018","journal-title":"Ultraschall Med"},{"key":"R10-20240829","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1148\/radiol.12111732","article-title":"Real-time sonoelastography for the evaluation of testicular lesions","volume":"263","author":"Aigner","year":"2012","journal-title":"Radiology"},{"key":"R11-20240829","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1007\/s00330-011-2312-2","article-title":"Real-time tissue elastography for testicular lesion assessment","volume":"22","author":"Goddi","year":"2012","journal-title":"Eur Radiol"},{"key":"R12-20240829","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/j.juro.2013.01.042","article-title":"Re: real-time tissue elastography for testicular lesion assessment","volume":"189","author":"Richie","year":"2013","journal-title":"J Urol"},{"key":"R13-20240829","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1148\/radiographics.22.1.g02ja14189","article-title":"From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation","volume":"22","author":"Woodward","year":"2002","journal-title":"Radiographics"},{"key":"R14-20240829","first-page":"160","article-title":"Elasto-sonography of the testis: preliminary experience","volume":"82","author":"Grasso","year":"2010","journal-title":"Arch Ital Urol Androl"},{"key":"R15-20240829","doi-asserted-by":"crossref","first-page":"20200063","DOI":"10.1259\/bjr.20200063","article-title":"The role of multiparametric ultrasound in the diagnosis of paediatric scrotal pathology","volume":"93","author":"Huang","year":"2020","journal-title":"italic> Br J Radiol"},{"key":"R16-20240829","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.urology.2010.12.035","article-title":"Early experience with contrast-enhanced ultrasound in the diagnosis of testicular masses: a feasibility study","volume":"77","author":"Lock","year":"2011","journal-title":"Urology"},{"key":"R17-20240829","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/RUQ.0000000000000156","article-title":"A novel microvascular flow technique: initial results in thyroids","volume":"32","author":"Machado","year":"2016","journal-title":"Ultrasound Q"},{"key":"R18-20240829","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1016\/j.ejrad.2016.09.026","article-title":"Superb microvascular imaging technology for ultrasound examinations: initial experiences for hepatic tumors","volume":"85","author":"Lee","year":"2016","journal-title":"Eur J Radiol"},{"key":"R19-20240829","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1007\/s00330-017-5016-4","article-title":"Microfow imaging: new Doppler technology to detect low-grade inflammation in patients with arthritis","volume":"28","author":"Lim","year":"2018","journal-title":"Eur Radiol"},{"key":"R20-20240829","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12894-022-00957-1","article-title":"Contrast-enhanced and microvascular ultrasound imaging features of testicular lymphoma: report of five cases and review literature","volume":"22","author":"Yang","year":"2022","journal-title":"italic> BMC Urol"},{"key":"R21-20240829","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1259\/bjr\/30029741","article-title":"Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis","volume":"85","author":"Huang","year":"2012","journal-title":"Br J Radiol"},{"key":"R22-20240829","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1365-2605.2008.00891.x","article-title":"Segmental testicular ischaemia: presentation, management and follow-up","volume":"32","author":"Gianfrilli","year":"2009","journal-title":"Int J Androl"},{"key":"R23-20240829","doi-asserted-by":"crossref","first-page":"345","DOI":"10.2214\/AJR.11.7997","article-title":"Contrast-enhanced ultrasound in the evaluation of focal testicular complications secondary to epididymitis","volume":"199","author":"Lung","year":"2012","journal-title":"AJR Am J Roentgenol"},{"key":"R24-20240829","doi-asserted-by":"crossref","first-page":"201","DOI":"10.4103\/aja202158","article-title":"Contrast-enhanced ultrasound as a valuable imaging modality for characterizing testicular lesions","volume":"24","author":"Yu","year":"2022","journal-title":"Asian J Androl"},{"key":"R25-20240829","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/1742271X15626195","article-title":"Sonographic imaging of extra-testicular focallesions: comparison of grey-scale, colour Doppler and contrast-enhanced ultrasound","volume":"24","author":"Rafailidis","year":"2016","journal-title":"Ultrasound"},{"key":"R26-20240829","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/j.eururo.2008.02.035","article-title":"Evaluation of prostate cancer detection with ultrasound real-time elastography: a comparison with step section pathological analysis after radical prostatectomy","volume":"54","author":"Salomon","year":"2008","journal-title":"Eur Urol"},{"key":"R27-20240829","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s11547-010-0518-z","article-title":"Role of sonoelastography in characterising breast nodules. Preliminary experience with 120 lesions","volume":"115","author":"Regini","year":"2010","journal-title":"Radiol Med"},{"key":"R28-20240829","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1055\/s-0029-1245699","article-title":"Typical and unusual sonoelastographic patterns of breast cystic lesions: impact on BI-RADS classification","volume":"33","author":"Chiorean","year":"2012","journal-title":"Ultraschall Med"},{"key":"R29-20240829","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/j.ultrasmedbio.2016.03.026","article-title":"Real-time elastography and contrast-enhanced ultrasonography in the evaluation of testicular masses: a comparative prospective study","volume":"42","author":"Schr\u00f6der","year":"2016","journal-title":"Ultrasound Med Biol"},{"key":"R30-20240829","doi-asserted-by":"crossref","first-page":"4078","DOI":"10.1210\/jc.2003-032024","article-title":"Human endocrine gland-derived vascular endothelial growth factor: expression early in development and in Leydig cell tumors suggests roles in normal and pathological testis angiogenesis","volume":"89","author":"Samson","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"R31-20240829","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1148\/radiol.14132718","article-title":"Differential diagnosis of nonpalpable testicular lesions: qualitative and quantitave contrast-enhanced US of benign and malignant testicular tumors","volume":"273","author":"Isidori","year":"2014","journal-title":"Radiology"},{"key":"R32-20240829","first-page":"201","article-title":"CEUS time intensity curves in the differentiation between Leydig cell carcinoma and seminoma: a multicenter study","volume":"37","author":"Drudi","year":"2016","journal-title":"Ultraschall Med"},{"key":"R33-20240829","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1055\/s-0034-1385038","article-title":"Contrast-enhanced ultrasound and real time elastography for the diagnosis of benign leydig cell tumors of the testis \u2013a single centre report on 13 cases","volume":"35","author":"Lock","year":"2014","journal-title":"Ultraschall Med"},{"key":"R34-20240829","doi-asserted-by":"crossref","first-page":"3586","DOI":"10.1007\/s00330-015-3766-4","article-title":"A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours","volume":"25","author":"Manganaro","year":"2015","journal-title":"Eur Radiol"},{"key":"R35-20240829","doi-asserted-by":"crossref","first-page":"180","DOI":"10.14366\/usg.15075","article-title":"Ultrasonography of the scrotum in adults","volume":"35","author":"K\u00fchn","year":"2016","journal-title":"Ultrasonography"},{"key":"R36-20240829","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.3389\/fonc.2019.01330","article-title":"T2-weighted image-based radiomics signature for discriminating between seminomas and nonseminoma","volume":"9","author":"Zhang","year":"2019","journal-title":"Front Oncol"}],"container-title":["Asian Journal of Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aja202235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:00:01Z","timestamp":1787756401000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aja202235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,10]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/aja202235","relation":{},"ISSN":["1745-7262","1008-682X"],"issn-type":[{"value":"1745-7262","type":"print"},{"value":"1008-682X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,10]]},"assertion":[{"value":"2021-12-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}