A pilot study of lymphotrophic nanoparticle-enhanced magnetic resonance imaging technique in early stage testicular cancer: A new method for noninvasive lymph node evaluation

Objectives. To evaluate whether lymphotrophic nanoparticle-enhanced magnetic resonance imaging (LNMRI) can be used as a method for detecting metastatic disease within retroperitoneal nodes in patients with testicular cancer. Methods. Stage I testicular cancer patients were prospectively enrolled and underwent a pelvic MRI both before and 24 hours after intravenous ferumoxtran-10 administration. Nodal sampling was performed by computed tomography-guided biopsy or laproscopic surgery and reviewed by a pathologist without knowledge of the LNMRI results. Results. In 18 patients, 42 nodes were sampled, of which 25 were benign and 17 were malignant. The sensitivity of LNMRI for malignant lymph node involvement was 88.2%, specificity was 92%, and the accuracy was 90.4%. On the other hand, the sensitivity of size criteria for detecting malignant nodes was 70.5%, the specificity was 68%, and the accuracy was 69%. Conclusions. Lymphotrophic nanoparticle-enhanced MRI is safe and accurate for detecting nodal metastases in patients with testicular cancer. Lymphotrophic nanoparticle-enhanced MRI yields higher sensitivity and specificity when compared with unenhanced MRI or conventional CT scanning. Although our results are encouraging, the precise role of this too[ in early stage testicular cancer remains to be determined.