Evaluating the Effectiveness of MRI Versus CT in Identifying Retroperitoneal Lymph Node Metastasis in Testicular Cancer: A Systematic Review and Meta-Analysis.

Testicular cancer, while rare, is a common malignancy among males aged 15-45 years and often spreads to retroperitoneal lymph nodes. This systematic review and meta-analysis compares the diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in detecting retroperitoneal lymph node metastasis. A comprehensive search was conducted up to January 25, 2024, using PubMed, MEDLINE, Web of Science, and Google Scholar. Studies comparing MRI and CT for detecting retroperitoneal lymph node involvement in adult males with testicular neoplasms were included. Data extraction covered study design, sample size, demographics, imaging techniques, and diagnostic outcomes. The Newcastle-Ottawa Scale was used to assess the risk of bias, and a random-effects model was applied for the meta-analysis. A total of 618 articles were identified, with four meeting the inclusion criteria. The studies reported high sensitivity for both MRI and CT, with MRI sensitivities ranging from 97% to 100% and CT sensitivities from 96% to 100%. Specificity findings were variable, with some studies suggesting similar or slightly higher values for MRI. Meta-analysis of three studies revealed no significant difference between MRI and CT in detecting retroperitoneal lymph node metastasis, with an odds ratio of 1.00 (95% CI: 0.54 to 1.86) and minimal heterogeneity (I² = 0%). These findings suggest both MRI and CT demonstrate comparable diagnostic accuracy in detecting retroperitoneal lymph node metastasis in testicular cancer. While MRI avoids ionizing radiation, it requires expert interpretation and is more costly, limiting its accessibility in some settings.