Proposed TART-RADS Classification for Testicular Ultrasound: Our Experience and Literature Review

Background: Testicular adrenal rest tumors (TARTs) are an important complication in patients with Congenital Adrenal Hyperplasia (CAH). Ultrasonography is the diagnostic modality of choice. In this study we examined the possibility of sonographic classification of TARTs in the Reporting and Data Systems (RADS) imaging format.Methods: 35 male patients with the diagnosis of congenital adrenal hyperplasia due to 21 hydroxylase deficiency were evaluated.Results: 19 patients had one or more sonographic findings of TARTs. No significant relation was found between 17 Hydroxyprogesterone (17 OH p), ACTH and androstenedione levels in patients with and without TARTs. Five sonographic patterns for testicular lesions were found. The five-stage classification of sonographic findings of TARTs is matched with histological classifications.Conclusion: This classification system will allow clinicians to perform more accurate approaches. In general, TARTS should be considered in male patients with CAH. Sonography is a good imaging modality for the diagnosis of TARTs. TART-RADS imaging of lesions will allow clinicians to develop more accurate and appropriate approaches