2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) for postchemotherapy seminoma residual lesions: a retrospective validation of the SEMPET trial.

Abstract

BACKGROUND:

2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) has been recommended in international guidelines in the evaluation of postchemotherapy seminoma residuals. Our trial was designed to validate these recommendations in a larger group of patients.

PATIENTS AND METHODS:

FDG-PET studies in patients with metastatic seminoma and residual masses after platinum-containing chemotherapy were correlated with either the histology of the resected lesion(s) or the clinical outcome.

RESULTS:

One hundred and seventy seven FDG-PET results were contributed. Of 127 eligible PET studies, 69% were true negative, 11% true positive, 6% false negative, and 15% false positive. We compared PET scans carried out before and after a cut-off level of 6 weeks after the end of the last chemotherapy cycle. PET sensitivity, specificity, negative predictive value (NPV), and positive predictive value were 50%, 77%, 91%, and 25%, respectively, before the cut-off and 82%, 90%, 95%, and 69% after the cut-off. PET accuracy significantly improved from 73% before to 88% after the cut-off (P=0.032).

CONCLUSION:

Our study confirms the high specificity, sensitivity, and NPV of FDG-PET for evaluating postchemotherapy seminoma residuals. When carried out at an adequate time point, FDG-PET remains a valuable tool for clinical decision-making in this clinical setting and spares patients unnecessary therapy.

• Authors: M Bachner, Y Loriot, M Gross-Goupil, P A Zucali, A Horwich, J-R Germa-Lluch, C Kollmannsberger, F Stoiber, A Fléchon, K Oechsle, S Gillessen, J Oldenburg, G Cohn-Cedermark, G Daugaard, F Morelli, A Sella, S Harland, M Kerst, J Gampe, C Dittrich, K Fizazi, M De Santis
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 23 Issue 1 Pg. 59-64 (Jan 2012) ISSN: 1569-8041 [Electronic] England
• PMID: 21460378 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Validation Study)

Chemical References

• Radiopharmaceuticals
• 2-fluoro-2-deoxyglucose-6-phosphate
• Glucose-6-Phosphate

Topics

• Glucose-6-Phosphate (analogs & derivatives)
• Humans
• Male
• Positron-Emission Tomography
• Radiopharmaceuticals
• Retrospective Studies
• Seminoma (diagnostic imaging)
• Sensitivity and Specificity
• Testicular Neoplasms (diagnostic imaging)