Characterization of testicular germ cell tumors: Whole-lesion histogram analysis of the apparent diffusion coefficient at 3T

Abstract

Purpose: To assess the values of parameters derived from whole-lesion histograms of the apparent diffusion coefficient (ADC) at 3T for the characterization of testicular germ cell tumors (TGCTs).

Materials and methods: A total of 24 men with TGCTs underwent 3T diffusion-weighted imaging. Fourteen tumors were pathologically confirmed as seminomas, and ten tumors were pathologically confirmed as nonseminomas. Whole-lesion histogram analysis of the ADC values was performed. A Mann-Whitney U test was employed to compare the differences in ADC histogram parameters between seminomas and nonseminomas. Receiver operating characteristic analysis was used to identify the cutoff values for each parameter for differentiating seminomas from nonseminomas; furthermore, the area under the curve (AUC) was calculated to evaluate the diagnostic accuracy.

Results: The median of 10th, 25th, 50th, 75th, and 90th percentiles and mean, minimum and maximum ADC values were all significantly reduced for seminomas compared with nonseminomas (p<0.05 for all). In contrast, the median of kurtosis and skewness of ADC values of seminomas were both significantly increased compared with those of nonseminomas (p=0.003 and 0.001, respectively). For differentiating nonseminomas from seminomas, the 10th percentile ADC yielded the highest AUC with a sensitivity and specificity of 100% and 92.86%, respectively.

Conclusion: Whole-lesion histogram analysis of ADCs might be used for preoperative characterization of TGCTs.

Keywords: Apparent diffusion coefficient; Diffusion-weighted imaging; Histogram analysis; Testicular germ cell neoplasms; Testicular neoplasms.