Musa Karim, Shazia F Khan, Shahla Zameer.
Sensitivity and specificity of ultrasound in the diagnosis of testicular tumors.
Ann Pak Inst Med Sci Jan ;2(3):183-7.

Objective: The objective of the study was to determine the sensitivity and specificity of ultrasonography (US) in the diagnosis of testicular turnouts. Setting and Design: This descriptive study was conducted in the Department of Radiology PIMS, Islamabad from July 2004 to July 2005. Materials and Methods: In this study fifty (50) patients with testicular swelling with the suspicion of mass lesion were included. High frequency Ultrasonography was used as primary screening test for the testicular lesions. Out of these, 20 patients had a simple hydrocele, simple intratesticular or epididymal cysts and were excluded from further intervention. Rest of the 30 patients were evaluated on the basis of their intra-testicular mass lesion. US findings were compared with the final diagnosis on histopathology. Data were analyzed on SPSS 10.0 version and 2 x 2 table was used to calculate test performance characteristic of US testes. Results: 19 patients (63.3%) were US positive for malignant mass lesion. Out of these 16 patients (53.3%) were confirmed in the final diagnosis and considered true positive while 3 (10%) patients as false positive and proved to be benign lesions on histopathology. 11 patients (36.7%) were US negative for malignant mass lesion and considered as having a benign lesion. All of them were negative on the histopathology and were considered as true negative. No false negative case was identified. The sensitivity, specificity, positive and negative predictive values and accuracy for malignant tumours were 100%, 78.6%, 84%, 100% and 90% respectively. Conclusion: The high sensitivity, specificity, predictive values and overall accuracy of -US for detection of testicular turnouts makes it a reliable 1° line diagnostic modality to be used in suspected testicular mass lesion. We suggest that orchidectomy should not be done indiscriminately in all the cases of intratesticular masses as considerable number of these prove to be benign lesions. Rather testis sparing biopsy should be performed where there is low suspicion for the mass to be malignant one.

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