Thomas Kerry L, Jeong Daniel, Montilla-Soler Jaime, Feuerlein Sebastian
Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Transl Androl Urol. 2020 Jan;9(Suppl 1):S3-S13. doi: 10.21037/tau.2019.07.01.
Testicular cancers are a group of uncommon malignancies that account for less than 1% of new cancer cases per year in the United States and globally. The disease typically affects men between the ages of 20-44, and the overwhelming majority of tumors are germ cell in origin. Most cases of testicular cancer are organ confined at diagnosis and have a good overall prognosis. Testicular cancers are staged by the tumor, node, metastasis, serum markers (TNMS) classification set forth by the American Joint Commission on Cancer staging. Diagnostic imaging plays a crucial role in initial staging, specifically in assessing the primary tumor prior to orchiectomy and evaluating for regional and/or distant metastasis. Multimodality imaging is used for initial staging, with ultrasound and computed tomography (CT) most commonly utilized. Diagnostic imaging is also important in evaluating response in patients who initially present with metastatic disease as well as in patients who are undergoing surveillance. Typically, CT is used for response assessment and surveillance, with magnetic resonance imaging (MRI) and positron emission tomography (PET) serving as adjunct modalities. This article reviews the role of various diagnostic imaging modalities and how they are employed in the diagnosis, staging, response assessment and surveillance of primary testicular cancer.
睾丸癌是一组罕见的恶性肿瘤，在美国和全球每年新增癌症病例中所占比例不到1%。该疾病通常影响20至44岁的男性，绝大多数肿瘤起源于生殖细胞。大多数睾丸癌病例在诊断时局限于器官内，总体预后良好。睾丸癌根据美国癌症联合委员会（AJCC）制定的肿瘤、淋巴结、转移、血清标志物（TNMS）分类系统进行分期。诊断性影像学在初始分期中起着关键作用，特别是在睾丸切除术前评估原发性肿瘤以及评估区域和/或远处转移方面。多模态成像用于初始分期，最常用的是超声和计算机断层扫描（CT）。诊断性影像学在评估初诊为转移性疾病的患者以及接受监测的患者的反应方面也很重要。通常，CT用于反应评估和监测，磁共振成像（MRI）和正电子发射断层扫描（PET）作为辅助手段。本文综述了各种诊断性影像学检查方法的作用，以及它们在原发性睾丸癌的诊断、分期、反应评估和监测中的应用。
