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Kumar S, Mehta PM, Chaudhary RK, Nepal P, Kumar D, Tirumani SH, Ojili V. MR imaging of the penis: What a radiologist needs to know! Abdom Radiol (NY) 2025; 50:1790-1810. [PMID: 39488809 DOI: 10.1007/s00261-024-04532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 08/09/2024] [Accepted: 08/13/2024] [Indexed: 11/04/2024]
Abstract
Magnetic resonance imaging (MRI) plays an important role in imaging of penile pathologies due to its excellent soft tissue resolution and multiplanar imaging capabilities. This imaging review describes the MRI protocols and anatomical considerations in penile pathologies. MRI not only serves as a complementary tool to ultrasound in evaluation of trauma, infections, inflammatory diseases, and malignancies, but is also used as the definitive imaging modality for evaluation of penile prosthesis and complex cases.
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Affiliation(s)
- Shruti Kumar
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 556, Little Rock, AR, 72205, USA.
| | - Parv M Mehta
- Department of Radiology, University of Texas Health, San Antonio, TX, USA
| | - Ranjit K Chaudhary
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Pankaj Nepal
- Department of Radiology, Inova Fairfax Hospital, Fairfax, VA, USA
| | - Devendra Kumar
- Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar
| | - Sree Harsha Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Vijayanadh Ojili
- Department of Radiology, University of Texas Health, San Antonio, TX, USA
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2
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Rajamohan N, Kapoor H, Khurana A, Nelson L, Ganesh HS, Khatri G, Nair RT. MR imaging of penile pathology and prostheses. Abdom Radiol (NY) 2025; 50:305-318. [PMID: 39066812 DOI: 10.1007/s00261-024-04417-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 07/30/2024]
Abstract
Penile MRI is a vital yet underutilized diagnostic tool that provides detailed information crucial for managing various penile pathologies. Due to its infrequent use, many radiology trainees lack confidence in interpreting these exams. This article reviews the anatomy, key technical considerations, and interpretive pearls for penile trauma, Peyronie's disease, priapism, penile neoplasms, prosthesis evaluation, and a few miscellaneous conditions. Through illustrative case examples, this review aims to enhance the understanding and proficiency of radiologists in performing and interpreting penile MRI in these clinical scenarios.
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Affiliation(s)
- Naveen Rajamohan
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9004, USA.
| | - Harit Kapoor
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St. HX315E, Lexington, KY, USA
| | - Aman Khurana
- Department of Radiology, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Leslie Nelson
- Department of Radiology, University of Wisconsin, Madison, 600 Highland Ave, Madison, WI, 53792, USA
| | - Halemane S Ganesh
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St. HX315E, Lexington, KY, USA
| | - Gaurav Khatri
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9004, USA
| | - Rashmi T Nair
- Department of Radiology, University of Kentucky Chandler Medical Center, 800 Rose St. HX315E, Lexington, KY, USA
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3
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Fujimoto K, Hashimoto D, Kim SW, Lee YS, Suzuki T, Nakata M, Kumegawa S, Asamura S, Yamada G. Novel erectile analyses revealed augmentable penile Lyve-1, the lymphatic marker, expression. Reprod Med Biol 2024; 23:e12570. [PMID: 38566911 PMCID: PMC10985380 DOI: 10.1002/rmb2.12570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The pathophysiology of penis extends to erectile dysfunction (ED) to conditions including sexually transmitted diseases (STDs) and cancer. To date, there has been little research evaluating vascular drainage from the penis. We aimed to evaluate penile blood flow in vivo and analyze its possible relationship with the lymphatic maker. Materials and Methods We established an in vivo system designed to assess the dynamic blood outflow from the corpus cavernosum (CC) by dye injection. To analyze lymphatic characteristics in the CC, the expression of Lyve-1, the key lymphatic endothelium marker, was examined by the in vitro system and lipopolysaccharide (LPS) injection to mimic the inflammatory conditions. Results A novel cavernography methods enable high-resolution morphological and functional blood drainage analysis. The expression of Lyve-1 was detected along the sinusoids. Furthermore, its prominent expression was also observed after penile LPS injection and in the erectile condition. Conclusions The current in vivo system will potentially contribute to the assessment of penile pathology from a novel viewpoint. In addition, current analyses revealed inducible Lyve-1 expression for LPS injection and the erection state, which requires further analyses on penile lymphatic system.
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Affiliation(s)
- Kota Fujimoto
- Department of Developmental Genetics, Institute of Advanced MedicineWakayama Medical UniversityWakayamaJapan
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Daiki Hashimoto
- Department of Developmental Genetics, Institute of Advanced MedicineWakayama Medical UniversityWakayamaJapan
- Department of Physiology and Regenerative Medicine, Faculty of MedicineKindai UniversityOsakaJapan
| | - Sang Woon Kim
- Department of Urology, Urological Science InstituteYonsei University College of MedicineSeoulKorea
| | - Yong Seung Lee
- Department of Urology, Urological Science InstituteYonsei University College of MedicineSeoulKorea
| | - Takuya Suzuki
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Masanori Nakata
- Department of Physiology, Faculty of MedicineWakayama Medical UniversityWakayamaJapan
| | - Shinji Kumegawa
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Shinichi Asamura
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Gen Yamada
- Department of Developmental Genetics, Institute of Advanced MedicineWakayama Medical UniversityWakayamaJapan
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
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4
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Lubner MG, Marko J, Hu R, Kawashima A, Potretzke TA, Frazier AA, Whiting R, Udager AM. Malignant Neoplasms of the Penis with Radiologic and Pathologic Correlation. Radiographics 2023; 43:e230025. [PMID: 37471245 DOI: 10.1148/rg.230025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Penile malignancy is the third most common male-specific genitourinary malignancy, with squamous cell carcinoma representing the most common histologic type. Squamous cell carcinoma is an epithelial malignancy, frequently developing from the mucosal surfaces of the foreskin, glans, and coronal sulcus and manifesting as a distal infiltrative or ulcerated mass. This typically occurs in men from the 6th to 8th decades of life, and risk factors include human papillomavirus, phimosis, presence of foreskin and poor hygiene, chronic inflammatory conditions such as lichen sclerosus, trauma, and smoking. Primary urethral malignancies including urothelial carcinoma and adenocarcinoma can occur but may lack this distal predilection. Sarcoma, melanoma, leukemia or lymphoma, and metastatic disease are less common sources of penile malignancy. Because of the sensitive nature of penile malignancies, there may be delays in seeking care and in subsequent diagnosis. Recently, the staging guidelines for penile cancer have been updated concurrently with a shift toward more penile-preserving therapies, which have led to a larger role of imaging in diagnosis, staging, and treatment planning for penile malignancies. A variety of imaging modalities may play a role in the identification and staging of penile malignancy, including an increased use of MRI for local staging of tumors, CT and PET/CT for identification of nodal and distant disease, and US for image-guided biopsy. The authors discuss an imaging approach to a spectrum of penile malignancies, with an emphasis on radiologic and pathologic correlation and how knowledge of normal tissue types and anatomic structures can aid in the diagnosis and staging of these tumors. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Meghan G Lubner
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Jamie Marko
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Rong Hu
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Akira Kawashima
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Theodora A Potretzke
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Aletta Ann Frazier
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Ryan Whiting
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
| | - Aaron M Udager
- From the Department of Radiology (M.G.L.) and Department of Pathology and Laboratory Medicine (R.H.), University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Sciences Center, 600 Highland Ave, Madison, WI 53792; American College of Radiology Institute for Radiologic Pathology, Silver Spring, Md (M.G.L., J.M., A.A.F.); Department of Radiology, Mayo Clinic Arizona, Scottsdale, Ariz (A.K.); Department of Radiology, Mayo Clinic, Rochester, Minn (T.A.P.); Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (A.A.F.); Department of Radiology, Moncrief Army Health Clinic, Fort Jackson, Columbia, SC (R.W.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.)
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5
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Ngweso S, Nzenza T, McMillan K, Sofield D, Lozinskiy M, Hayne D. Current trends in penile cancer survivorship amongst remote patients and Aboriginal people in Western Australia. ANZ J Surg 2023; 93:534-540. [PMID: 36478516 DOI: 10.1111/ans.18177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 08/27/2021] [Accepted: 11/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Penile cancer is a rare urological malignancy, accounting for less than 1% of all cancers in males. Given its rarity, few studies exist reporting survival outcomes. The primary objective of this project was to review the mortality of patients diagnosed with penile cancer in Western Australia between 1992 and 2017 and to determine if Aboriginal and Torres Strait Islander people and patients in rural and remote regions experience discrepancies in survival outcomes. METHODS All cases of penile cancer recorded within the Western Australia Cancer Registry between 1992 and 2017 were reviewed. Analysis was performed using chi-squared test of association, binomial logistic regression and survival analysis was conducted using Kaplan Meier and Cox Regression analysis. RESULTS One hundred eighty-six cases of penile cancer were identified; 62 patients (33%) were from regional or remote locations and nine patients (4.8%) were Aboriginal. 13 of the regional or remote patients and 5 of the Aboriginal patients died from penile cancer. Patients who were Aboriginal (HR 6.512, CI 2.123-19.968; P = 0.001) or from regional or remote Western Australia (HR 2.382, CI 1.050-5.401; P = 0.038) were at an increased risk of penile cancer-specific mortality. CONCLUSIONS Aboriginal people with penile cancer and men from regional and remote Western Australia experience worse penile cancer-specific survival outcomes.
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Affiliation(s)
- Simeon Ngweso
- Department of Urology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group
| | - Tatenda Nzenza
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Kevin McMillan
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - David Sofield
- Department of Urology, Bethesda Hospital, Claremont, Western Australia, Australia
- Department of Urology, St John of God Hospital, Subiaco, Western Australia, Australia
| | | | - Dickon Hayne
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Urology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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6
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Yamaguchi T, Sugiyama Y, Tanaka T, Kimura T, Yumura Y, Nakano M, Sugiyama T, Miura N, Goya M, Yamamoto A, Takahashi S, Miura Y, Tsuzuki T, Masumori N, Nishiyama H, Yao M, Koie T, Miyake H, Saika T, Saito S, Akimoto T, Tamada T, Ando Y, Takahashi S, Suzuki T, Hinotsu S, Kamba T. Summary of the Clinical Practice Guidelines for Penile Cancer 2021 by the Japanese Urological Association. Int J Urol 2022; 29:780-792. [DOI: 10.1111/iju.14924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/25/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Takahiro Yamaguchi
- Department of Urology Faculty of Life Sciences Kumamoto University Kumamoto Japan
| | - Yutaka Sugiyama
- Department of Urology Faculty of Life Sciences Kumamoto University Kumamoto Japan
| | - Toshiaki Tanaka
- Department of Urology Sapporo Medical University Sapporo Japan
| | - Tomokazu Kimura
- Department of Urology Faculty of Medicine, University of Tsukuba Tsukuba Japan
| | - Yasushi Yumura
- Reproduction Center Yokohama City University Medical Center Yokohama Japan
| | - Masahiro Nakano
- Department of Endourology Gifu Prefectural General Medical Center Gifu Japan
| | - Takayuki Sugiyama
- Department of Urology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Noriyoshi Miura
- Department of Urology Ehime University Graduate School of Medicine Toon Japan
| | - Masato Goya
- Department of Urology Chubu Tokushukai Hospital Kitanakagusuku Japan
| | - Akira Yamamoto
- Department of Radiology Kawasaki Medical School Kurashiki Japan
| | - Satoru Takahashi
- Imaging Research Center Takatsuki General Hospital Takatsuki Japan
| | - Yuji Miura
- Department of Clinical Oncology Toranomon Hospital Tokyo Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology Aichi Medical University Hospital Nagakute Japan
| | - Naoya Masumori
- Department of Urology Sapporo Medical University Sapporo Japan
| | - Hiroyuki Nishiyama
- Department of Urology Faculty of Medicine, University of Tsukuba Tsukuba Japan
| | - Masahiro Yao
- Department of Urology Yokohama City University Yokohama Japan
| | - Takuya Koie
- Department of Urology, Graduate School of Medicine Gifu University Gifu Japan
| | - Hideaki Miyake
- Department of Urology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Takashi Saika
- Department of Urology Ehime University Graduate School of Medicine Toon Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of Medicine University of the Ryukyus Nishihara Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology National Cancer Center Hospital East Kashiwa Japan
| | - Tsutomu Tamada
- Department of Radiology Kawasaki Medical School Kurashiki Japan
| | - Yuichi Ando
- Department of Chemotherapy Nagoya University Hospital Nagoya Japan
| | - Satoru Takahashi
- Department of Urology Nihon University School of Medicine Tokyo Japan
| | | | - Shiro Hinotsu
- Department of Biostatistics and Clinical Epidemiology Sapporo Medical University Sapporo Japan
| | - Tomomi Kamba
- Department of Urology Faculty of Life Sciences Kumamoto University Kumamoto Japan
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7
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Galgano SJ, Norton JC, Porter KK, West JT, Rais-Bahrami S. Imaging for the Initial Staging and Post-Treatment Surveillance of Penile Squamous Cell Carcinoma. Diagnostics (Basel) 2022; 12:diagnostics12010170. [PMID: 35054337 PMCID: PMC8774300 DOI: 10.3390/diagnostics12010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 12/24/2022] Open
Abstract
Although relatively rare in the United States, penile squamous cell carcinoma is encountered worldwide at a higher rate. Initial diagnosis is often made on clinical exam, as almost all of these lesions are externally visible and amenable to biopsy. In distinction to other types of malignancies, penile cancer relies heavily on clinical nodal staging of the inguinal lymph node chains. As with all cancers, imaging plays a role in the initial staging, restaging, and surveillance of these patients. The aim of this manuscript is to highlight the applications, advantages, and limitations of different imaging modalities in the evaluation of penile cancer, including ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography.
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Affiliation(s)
- Samuel J. Galgano
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (S.J.G.); (K.K.P.); (J.T.W.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - John C. Norton
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - Kristin K. Porter
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (S.J.G.); (K.K.P.); (J.T.W.)
| | - Janelle T. West
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (S.J.G.); (K.K.P.); (J.T.W.)
| | - Soroush Rais-Bahrami
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (S.J.G.); (K.K.P.); (J.T.W.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
- Correspondence:
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Diagnostic Performance of Magnetic Resonance Imaging for Preoperative Local Staging of Penile Cancer: A Systematic Review and Meta-Analysis. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11157090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Invasion of the tunica albuginea (TA) and/or urethra are key factors in determining the feasibility of organ-preserving surgery in penile cancer (PC). Magnetic resonance imaging (MRI) appeared to be a promising technique for preoperative local staging. We performed a systematic review (SR) and pooled meta-analysis to investigate the diagnostic performance of MRI in preoperative local staging of primary PC. An SR up to May 2021 was performed according to the PRISMA statement. The diagnostic performance of MRI was evaluated according to TA invasion, urethra invasion, and pT-stage ≥ 2. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) from eligible studies were pooled and summary receiver operating characteristic (SROC) curves were constructed. Overall, seven qualified studies were deemed suitable. Diagnostic performance of MRI showed an accuracy of 0.89 for TA invasion (sensitivity 0.78, PPV 0.79, specificity 0.91, and NPV 0.90); an accuracy of 0.88 for urethra invasion (sensitivity 0.65, PPV 0.46, specificity 0.86, and NPV 0.93); an accuracy of 0.90 for pT ≥ 2 (sensitivity 0.86, PPV 0.84, specificity 0.70, and NPV 0.73).Currently available evidence indicates that MRI might be a one-stop shop for local staging of primary PC and play a central role with regard to conservative surgical management.
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Abstract
This article reviews the anatomy and magnetic resonance imaging (MRI) appearance of the penis. The recommended technique for MRI of the penis is outlined, with discussion of the benefits and drawbacks to imaging the penis after artificial erection. Common penile pathologies are reviewed, with a summary of their clinical features, MRI appearance, and treatment. The ability to demonstrate the erectile bodies and vasculature helps to evaluate vascular pathologies such as priapism, Mondor disease, and cavernosal thrombosis. MRI is also a useful tool to assess for traumatic abnormalities of the penis, with the depiction of soft tissue anatomy and fascial layers allowing for evaluation of penile fracture and penile contusion. Malignant disease of the penis is also reviewed, including squamous cell carcinoma, urethral carcinoma, metastases, and rare neoplasms. Staging of these neoplasms is addressed, with discussion of how MRI can be used to assess the extent of tumor involvement. MRI also clearly demonstrates the tunica albuginea, which allows for evaluation of Peyronie's disease.
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11
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Oldan JD, Shah SN, Rose TL. Applications of PET/MR Imaging in Urogynecologic and Genitourinary Cancers. Magn Reson Imaging Clin N Am 2017; 25:335-350. [PMID: 28390533 DOI: 10.1016/j.mric.2016.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Positron emission tomograph (PET)-magnetic resonance (MR) is a new modality combining PET and MR. In gynecologic cancers it can be used for staging of cervical and endometrial cancer, planning of radiation therapy in cervical cancer, assessing response to chemotherapy in ovarian cancer, and detection of recurrence in most gynecologic cancers. It is being explored for prostate cancer and other genitourinary cancers, but is still in experimental stages.
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Affiliation(s)
- Jorge D Oldan
- Nuclear Medicine, Department of Radiology, University of North Carolina School of Medicine, Chairman's Office, 2006 Old Clinic, CB# 7510, Chapel Hill, NC 27599, USA.
| | - Shetal N Shah
- Abdominal Imaging Section and Nuclear Medicine Department, Imaging Institute and Taussig Cancer Institute, Cleveland Clinic Main Campus, Mail Code JB3, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Tracy Lynn Rose
- Hematology-Oncology, N.C. Cancer Hospital, 101 Manning Drive, Second Floor, Chapel Hill, NC 27514, USA
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12
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Dirrig H, Drees R, Lam R. Use of dual-phase contrast computed tomography for evaluation of the normal canine male genital tract. J Small Anim Pract 2016; 57:679-689. [PMID: 27590449 DOI: 10.1111/jsap.12550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/29/2016] [Accepted: 07/14/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To evaluate the use of dual-phase contrast-enhanced computed tomography for the depiction of the features of the male genital tract, highlighting differences between entire and neutered dogs. METHODS Computed tomography exams of 23 entire and 23 neutered male dogs with no history of urogenital disease were included in this retrospective study, with exams acquired pre-, 30 and 98·9 ±27·4 seconds after intravenous contrast administration. The genital structures were subjectively evaluated for visibility, contrast enhancement and enhancement pattern and differences between entire and neutered dogs were described. Objective measurements of attenuation and size of the prostatic tissue were acquired. RESULTS The root, body and glans of the penis could be evaluated in all dogs and appeared larger in entire dogs, though objective measurements could not be reliably made because these structures are small and curved. There was contrast enhancement of the cavernous structures, most reliably in the bulb and corpus spongiosum and most frequently in entire dogs in the delayed post-contrast phase. In entire dogs, the small testicular vessels most commonly had a vermiform shape in the early post-contrast phase, and a homogeneous appearance in the delayed phase. Sternal recumbency with the coxofemoral joints extended improved visibility of the genital structures. CLINICAL SIGNIFICANCE Dual-phase contrast-enhanced computed tomography is useful for depiction of the structures of the male genital tract, with the early phase especially highlighting the vascular and the delayed phase the cavernous structures.
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Affiliation(s)
- H Dirrig
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA
| | - R Drees
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA
| | - R Lam
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA
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Lucchesi FR, Reis RB, Faria EF, Machado RD, Rossini RR, Borregales LD, Silva GEB, Muglia VF. Incremental value of MRI for preoperative penile cancer staging. J Magn Reson Imaging 2016; 45:118-124. [DOI: 10.1002/jmri.25339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/25/2016] [Indexed: 11/07/2022] Open
Affiliation(s)
| | - Rodoldo Borges Reis
- Department of Surgery; Urology Division, Ribeirao Preto Medical School, University of Sao Paulo; Brazil
| | - Eliney Ferreira Faria
- Department of Urology; Barretos Cancer Hospital, Pio XII Foundation; Barretos Brazil
| | - Roberto Dias Machado
- Department of Urology; Barretos Cancer Hospital, Pio XII Foundation; Barretos Brazil
| | | | | | | | - Valdair Francisco Muglia
- Internal Medicine Department; Imaging Division, Ribeirao Preto Medical School, University of Sao Paulo; Brazil
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