super(18)F-FDG PET/CT impact on testicular tumours clinical management

• Published in: European journal of nuclear medicine and molecular imaging 2014-04, Vol.41 (4), p.668-673
• Main Authors: Ambrosini, Valentina, Zucchini, Giorgia, Nicolini, Silvia, Berselli, Annalisa, Nanni, Cristina, Allegri, Vincenzo, Martoni, Andrea, Domenico, Rubello, Cricca, Antonia, Fanti, Stefano
• Format: Article
• Language: English
• Subjects: Chemotherapy
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-013-2624-3

Purpose: Testicular tumour is the most common malignancy in young men. The diagnostic work-up is mainly based on morphological imaging. The aim of our study was to evaluate the clinical impact of super(18)F-FDG PET/CT in patients with testicular tumour. Methods: We retrospectively evaluated all patients studied by super(18)F-FDG PET/CT at our centre. Inclusion criteria were: pathological confirmation of testicular tumour, contrast-enhanced CT scan performed within a month of the PET/CT scan, and clinical/imaging follow-up performed at the Oncology Unit of our hospital. Overall, 56 patients were enrolled and 121 PET/CT scans were evaluated. super(18)F-FDG PET/CT was performed following standard procedures and the results were compared with clinical, imaging and follow-up data. Clinicians were contacted to enquire whether the PET/CT scan influenced the patient's management. Answers were scored as follows: start/continue chemotherapy or radiotherapy, indication for surgery of secondary lesions, and clinical surveillance. Results: On a scan basis, 51 seminoma and 70 nonseminoma (NS) cases were reviewed. Of the 121 cases. 32 were found to be true-positive, 74 true-negative, 8 false-positive and 6 false-negative by PET/CT. PET/CT showed good sensitivity and specificity for seminoma lesion detection (92 % and 84 %, respectively), but its sensitivity was lower for NS forms (sensitivity and specificity 77 % and 95 %, respectively). The PET/CT scan influenced the clinical management of 47 of 51 seminomas (in 6 chemotherapy was started/continued, in 3 radiotherapy was started/continued, in 2 surgery of secondary lesions was performed, and in 36 clinical surveillance was considered appropriate), and 59 of 70 NS (in 18 therapy/surgery was started/continued, and in 41 clinical surveillance was considered appropriate). Conclusion: Our preliminary data demonstrate the potential usefulness of PET/CT for the assessment of patients with testicular tumour. It provides valuable information for the clinical management, particularly for clinical surveillance, post-therapy assessment and when relapse is suspected.