SynthesisBJU international2026
Contrast-enhanced ultrasonography vs MRI for indeterminate testicular lesions: a systematic review and meta-analysis.
Synthesis in BJU international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Indirect evidence and cautious sequencing in indeterminate testicular lesions.BJU international · 2026Article
- Response to: 'Indirect evidence and cautious sequencing in indeterminate testicular lesions'.BJU international · 2026Article
- Multiparametric Ultrasound for Characterisation of Testicular Lesions: Beyond Orchiectomy.Diagnostics (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo conduct a systematic review and meta-analysis to indirectly compare the diagnostic performance of contrast-enhanced ultrasonography (CEUS) and magnetic resonance imaging (MRI) in the evaluation of indeterminate testicular lesions and to explore their potential roles in guiding clinical decision-making.
methodsPubMed, Web of Science, and Scopus were searched in August 2025. Eligible studies were prospective or retrospective cohorts evaluating CEUS or MRI in small, impalpable, or incidentally detected testicular lesions, with histopathology or clinical/radiological follow-up as reference standard. Two reviewers independently performed selection, data extraction, and Quality Assessment of Diagnostic Accuracy Studies-2 tool assessment. Random-effects meta-analyses and meta-regression were conducted in R (R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria). This review was registered in the Prospective Register of Systematic Reviews (CRD420251113920).
resultsA total of 12 studies including 912 patients with 920 lesions (279 malignant, 641 benign) were analysed. CEUS showed a sensitivity of 90% (95% confidence interval [CI] 80-95%) and specificity of 74% (95% CI 47-91%), while MRI achieved a sensitivity of 94% (95% CI 88-97%) and specificity of 84% (95% CI 72-91%). CEUS provided a higher negative predictive value (NPV; 96% vs 88%), whereas MRI demonstrated superior positive predictive value (PPV; 83% vs 65%) and accuracy (91% vs 80%). Differences in PPV and accuracy significantly favoured MRI (P = 0.025 and P = 0.031). Limitations included protocol heterogeneity, operator dependence, and small sample sizes.
conclusionBoth CEUS and MRI demonstrated a high sensitivity and NPV, supporting their role in excluding malignancy. CEUS, with accessibility, low cost, and particularly high NPV, may serve as the first-line adjunct, while MRI is best reserved for equivocal or higher-risk cases. No funding was received for this study.
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Registered trials
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