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

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. DittrichK. Fizazi, M. De Santis*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)59-64
Number of pages6
JournalAnnals of Oncology
Volume23
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Keywords

  • Chemotherapy
  • FDG-PET
  • Follow-up
  • Postchemotherapy residual lesions
  • Seminoma
  • Testicular cancer

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