Testicular microlithiasis imaging and follow-up: guidelines of the ESUR scrotal imaging subcommittee

Jonathan Richenberg, Jane Belfield, Parvati Ramchandani, Laurence Rocher, Simon Freeman, Athina C. Tsili, Faye Cuthbert, Michal Studniarek, Michele Bertolotto, Ahmet Tuncay Turgut, Vikram Dogra, Lorenzo E. Derchi

Research output: Contribution to journalArticlepeer-review


Objectives: The subcommittee on scrotal imaging, appointed by the board of the European Society of Urogenital Radiology (ESUR), have produced guidelines on imaging and follow-up in testicular microlithiasis (TML).

Methods: The authors and a superintendent university librarian independently performed a computer-assisted literature search of medical databases: MEDLINE and EMBASE. A further parallel literature search was made for the genetic conditions Klinefelter’s syndrome and McCune-Albright syndrome.

Results: Proposed guidelines are: follow-up is not advised in patients with isolated TML in the absence of risk factors (see Key Points below); annual ultrasound (US) is advised for patients with risk factors, up to the age of 55; if TML is found with a testicular mass, urgent referral to a specialist centre is advised.

Conclusion: Consensus opinion of the scrotal subcommittee of the ESUR is that the presence of TML alone in the absence of other risk factors is not an indication for regular scrotal US, further US screening or biopsy. US is recommended in the follow-up of patients at risk, where risk factors other than microlithiasis are present. Risk factors are discussed and the literature and recommended guidelines are presented in this article.

Key Points: • Follow up advised only in patients with TML and additional risk factors.

• Annual US advised for patients with risk factors up to age 55.

• If TML is found with testicular mass, urgent specialist referral advised.

• Risk factors – personal/ family history of GCT, maldescent, orchidopexy, testicular atrophy.

Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalEuropean Radiology
Issue number2
Publication statusPublished - 2014


  • Germ cell tumour
  • Testicular microlithiasis
  • Testis microcalcification
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)


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