There is no relevant literature regarding the use of MRI of the abdomen and pelvis in these patients. MRI Pelvis (Scrotum) MRI is not routinely used as the initial examination to evaluate scrotal pathology given its uncertain clinical utility when used in addition to standard US [37,38]. In select cases, it could be help distinguish between an intratesticular and extratesticular mass when this cannot be confirmed clinically or with US [8]. MRI may aid in the diagnosis of a primary testicular mass, mostly focusing on differential diagnosis between benign and malignant testicular masses [39]. Quantitative enhancement patterns may be useful to distinguish testicular seminoma from Leydig cell tumors in direct comparison, but it is uncertain how they would perform in a routine clinical practice [40]. Nuclear Medicine Scan Scrotum Nuclear scan of the scrotum is not routinely used as an initial imaging modality for the evaluation of newly diagnosed palpable scrotal abnormality in patients without a history of trauma or infection. There is no relevant literature regarding the use of nuclear scans of the scrotum in these patients. US Duplex Doppler Scrotum The combination of grayscale and color-power Doppler US can significantly improve the specificity of B-mode US in scrotal lesion characterization [1,32]. US duplex may be able to differentiate a solid mass from a mass-like hematoma. which will be avascular (can occur without trauma). Nevertheless, duplex US does not allow a definitive differentiation of malignancies from a variety of benign conditions, such as orchitis, dermoid cyst, granuloma, focal fibrosis, adrenal rest, and papillary cystadenoma. In fact, those lesions can mimic cancer, and, as a consequence, the specificity of duplex US examination of the scrotum is lower than its sensitivity [34]. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list.
Newly Diagnosed Palpable Scrotal Abnormality. There is no relevant literature regarding the use of MRI of the abdomen and pelvis in these patients. MRI Pelvis (Scrotum) MRI is not routinely used as the initial examination to evaluate scrotal pathology given its uncertain clinical utility when used in addition to standard US [37,38]. In select cases, it could be help distinguish between an intratesticular and extratesticular mass when this cannot be confirmed clinically or with US [8]. MRI may aid in the diagnosis of a primary testicular mass, mostly focusing on differential diagnosis between benign and malignant testicular masses [39]. Quantitative enhancement patterns may be useful to distinguish testicular seminoma from Leydig cell tumors in direct comparison, but it is uncertain how they would perform in a routine clinical practice [40]. Nuclear Medicine Scan Scrotum Nuclear scan of the scrotum is not routinely used as an initial imaging modality for the evaluation of newly diagnosed palpable scrotal abnormality in patients without a history of trauma or infection. There is no relevant literature regarding the use of nuclear scans of the scrotum in these patients. US Duplex Doppler Scrotum The combination of grayscale and color-power Doppler US can significantly improve the specificity of B-mode US in scrotal lesion characterization [1,32]. US duplex may be able to differentiate a solid mass from a mass-like hematoma. which will be avascular (can occur without trauma). Nevertheless, duplex US does not allow a definitive differentiation of malignancies from a variety of benign conditions, such as orchitis, dermoid cyst, granuloma, focal fibrosis, adrenal rest, and papillary cystadenoma. In fact, those lesions can mimic cancer, and, as a consequence, the specificity of duplex US examination of the scrotum is lower than its sensitivity [34]. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list.