The role of 18F-FDG PET/CT in the management of testicular cancers. Issue 7 (July 2015) - Cook, Gary J.
Abstract : Objectives: The aim of this study was to determine the utility of fluorine-18 fluorodeoxyglucose PET/computed tomography ( 18 F-FDG PET/CT) in managing testicular cancer. Patients and methods: Sixty-two patients (29 seminoma, 28 nonseminoma and five mixed) underwent 75 18 F-FDG PET/CT scans (16 scans for primary staging, 44 for residual masses and 15 for rising tumour markers). Follow-up histology, clinical scans and tumour marker results were included for retrospective analysis. Results: (i) Primary staging: eight of 11 patients with equivocal CT scans had true-negative 18 F-FDG PET/CT scans. Five high-risk patients with normal stage 1 CT scans had negative 18 F-FDG PET/CT scans, but two subsequently relapsed. (ii) Residual masses: of the 20 scans interpreted as showing viable disease, five were false positive. Nineteen scans were negative (18 true negative and one false negative). (iii) Rising tumour markers: of the 15 scans, two were false negative and 13 were true positive. Conclusion: 18 F-FDG PET/CT is helpful when primary staging CT scans are equivocal but insufficiently sensitive to predict relapse in high-risk patients with normal CT scans. With residual masses, a negative scan is rarely associated with relapse. 18 F-FDG PET/CT is helpful in defining recurrent disease in the majority of patients with rising tumour markers and negative CT scans.