Thursday, April 21, 2011

Ultrasound or CT for Testicular Imaging

I came across an interesting article regarding CT being used to watch for the spread of testicular cancer in patients electing not to have an orchiectomy for an early lesion.  These patients were either older, or men who feared the side effects of orchiectomy such as impotence.  It seems since the early 1980s CT has been the method of choice for checking to see if the retroperitoneal lymph nodes become involved.  The article further goes on to discuss the secondary cancers associated with this form of surveillance. I would think ultrasound would be a less hazardous approach in this regard.  But I am only a Sonographer.

"In the 1990s, nearly half of patients diagnosed with early-stage disease were treated with orchiectomy (testicle removal) alone. For those patients, the US National Comprehensive Cancer Network Guidelines recommend a total of 15 CT scans in the first five years after surgery (every two to three months for the first year, then tapering off each consecutive year) to check for new signs of disease. After four years, CT scans are recommended just once annually.

Excessive CT scanning has been the topic of considerable debate in recent years; as the technology has become better at detecting disease, it has been used with far more frequency, exposing more people to ionizing radiation, which can cause cancer at high doses. “What has happened is that because CT images are so diagnostically useful, physicians request them for their patients in great numbers, so the concerns are really based upon the fact that 80 million CT scans are performed every year in the US,” said Dr. Boone. “That is a huge number.” 

Here is the link: