2-18fluoro-deoxy-D-glucose positron emission tomography is a reliable predictor for viable tumor in postchemotherapy seminoma: an update of the prospective multicentric SEMPET trial.
OBJECTIVE
To define the clinical value of 2-18fluoro-deoxy-D-glucose positron emission tomography (FDG PET) as a predictor for viable residual tumor in postchemotherapy seminoma residuals in a prospective multicentric trial.


METHODS
FDG PET studies in patients with metastatic pure seminoma who had radiographically defined postchemotherapy residual masses were correlated with either the histology of the resected lesion or the clinical outcome documented by computer tomography (CT), tumor markers, and/or physical examination during follow-up. The size of the residual lesions on CT, either >3 cm or < or =3 cm, was correlated with the presence or absence of viable residual tumor.


RESULTS
Fifty-six FDG PET scans of 51 patients were assessable. All 19 cases with residual lesions >3 cm and 35 (95%) of 37 with residual lesions < or =3 cm were correctly predicted by FDG PET. The specificity, sensitivity, positive predictive value, and negative predictive value of FDG PET were 100% (95% CI, 92% to 100%), 80% (95% CI, 44% to 95%), 100%, and 96%, respectively, versus 74% (95% CI, 58% to 85%), 70% (95% CI, 34% to 90%), 37%, and 92%, respectively, for CT discrimination of the residual tumor by size (>3 cm/< or =3 cm).


CONCLUSIONS
This investigation confirms that FDG PET is the best predictor of viable residual tumor in postchemotherapy seminoma residuals and should be used as a standard tool for clinical decision making in this patient group.
De Santis
Maria
M
Department of Medical Oncology, Kaiser Franz Josef Spital, Kundratstrasse 3, A-1100 Wien, Austria.
Becherer
Alexander
A
Bokemeyer
Carsten
C
Stoiber
Franz
F
Oechsle
Karin
K
Sellner
Franz
F
Lang
Alois
A
Kletter
Kurt
K
Dohmen
Bernhard M
BM
Dittrich
Christian
C
Pont
Jörg
J
D001317:Austria; D002986:Clinical Trials as Topic; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018239:Seminoma / Q000000981:diagnostic imaging* / Q000188:drug therapy; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18