A systematic review on the use of qualitative and quantitative contrast-enhanced ultrasound in diagnosing testicular abnormalities.

Abstract Greyscale and colour doppler ultrasound (CDUS) are the standard when investigating testicular lesions. However, they cannot provide information on the microvasculature. As such, differentiating benign from malignant tumours is challenging. Contrast-enhanced ultrasound (CEUS) uses ultrasound contrast agents (UCA) which are exclusively intravascular to image the microvasculature. This review assessed CEUS outcomes in investigating intra-testicular lesions and concluded that qualitative CEUS provides the most advantage by confirming vascularity, thus differentiating non-neoplastic from neoplastic lesions with added confidence, allowing for appropriate management. Whilst results for quantitative CEUS are promising in distinguishing malignant from benign neoplasms, further research on its benefits is required.