The study, which was published as preprint on researchsquare.com, did not show any significant reduction in sensitivity as compared to CT and MRI does not expose to radiation.
Key Takeaway
Why It’s Important
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To save patients from radiation exposure, the imaging for stage 1 testicular cancer is moving away from serial CTs to MRIs.
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Recent research suggests that MRI could be used in place of CT in the treatment of metastatic disease.
Study Design
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This prospective, non-inferiority trial included 84 men with metastatic testicular cancer.
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The pretreatment staging scan as well as the initial posttreatment evaluation scan were done on patients who had undergone contrast enhancement, abdominal thoracoabdominal CT, and whole-body MRI. This included diffusion-weighted whole-body imaging with background signal suppression.
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Pretreatment MRI and CT were a average of 5 days apart and posttreatment MRI and CT were both performed on the same day.
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The authors evaluated the specificity and sensitivity of the two modality.
Key Results
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MRI was sensitive to 98% in identifying metastases and specific to 75% to detect them at the level of the patient.
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One MRI result was a false positive and two of them were false negatives.
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At the level of lesion, MRI had 99% sensitivity and 78% specificity, whereas CT had 98 percent sensitivity and 88% specificity.
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MRI sensitiveness was not less to CT (difference 0.57 percent).).
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The interobserver agreement was significant between CT and MRI.
Limitations
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The diagnosis of lesion was not confirmed by pathology. Instead, CT was used to refer to the pre- or post-treatment scans.
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The knowledge of the diagnosis led to a bias toward judging lesions as malignant and thus increasing the sensitivity of the patient and decreasing the specificity.
Disclosures
This is a brief summary of a research paper that was published as a preprint, “Can Whole-body MRI replace CT in the treatment of Metastatic Testicular Cancer?” A Prospective, Non-inferiority Study,” led by Solveig Kark Abildtrup Larsen, MD from Aarhus University Hospital, Denmark. The study is not peer-reviewed, and can be found at researchsquare.com.
M. Alexander Otto is a physician assistant who holds a master’s level in medical science. He is an award-winning medical journalist who has worked for several major news organizations prior to joining Medscape. He is a MIT Knight Science Journalism fellow. Email: [email protected]
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