title: 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.
  
  
  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).
  
  
  CONCLUSIONS
  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: ACR-ITR VIEnna/CEADDP, LBI-ACR VIEnna, and KFJ-Spital, Vienna, Austria.
authors: M
authors: M
authors: Bachner
authors: Institut Gustave Roussy, Villejuif, France.
authors: Y
authors: Y
authors: Loriot
authors: Institut Gustave Roussy, Villejuif, France.
authors: M
authors: M
authors: Gross-Goupil
authors: Istituto Clinico Humanitas IRCCS, Rozzano (Milan), Italian Germ Cell Cancer Group.
authors: P A
authors: PA
authors: Zucali
authors: The Royal Marsden Hospital, London and Surrey, UK.
authors: A
authors: A
authors: Horwich
authors: Institut Català d'Oncologia, Barcelona, Spain.
authors: J-R
authors: JR
authors: Germa-Lluch
authors: BC Cancer Agency-Vancouver Cancer Center, Vancouver, Canada.
authors: C
authors: C
authors: Kollmannsberger
authors: Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
authors: F
authors: F
authors: Stoiber
authors: Centre Leon Berard, Lyon, France.
authors: A
authors: A
authors: Fléchon
authors: Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
authors: K
authors: K
authors: Oechsle
authors: Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors: S
authors: S
authors: Gillessen
authors: The Norwegian Radium Hospital, Oslo, Norway.
authors: J
authors: J
authors: Oldenburg
authors: Department of Oncology-Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors: G
authors: G
authors: Cohn-Cedermark
authors: Department of Oncology, 5073 Rigshospitalet, Copenhagen, Denmark.
authors: G
authors: G
authors: Daugaard
authors: Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors: F
authors: F
authors: Morelli
authors: Assaf Harofeh Medical Center, Zerifin, Israel.
authors: A
authors: A
authors: Sella
authors: University College Hospital London, London, UK.
authors: S
authors: S
authors: Harland
authors: The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors: M
authors: M
authors: Kerst
authors: Max Planck Institute for Demographic Research, Rostock, Germany.
authors: J
authors: J
authors: Gampe
authors: ACR-ITR VIEnna/CEADDP, LBI-ACR VIEnna, and KFJ-Spital, Vienna, Austria.
authors: C
authors: C
authors: Dittrich
authors: Institut Gustave Roussy, Villejuif, France.
authors: K
authors: K
authors: Fizazi
authors: ACR-ITR VIEnna/CEADDP, LBI-ACR VIEnna, and KFJ-Spital, Vienna, Austria. Electronic address: maria.desantis@wienkav.at.
authors: M
authors: M
authors: De Santis
mesh_terms: D019298:Glucose-6-Phosphate / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D018239:Seminoma / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; C047515:2-fluoro-2-deoxyglucose-6-phosphate; D019298:Glucose-6-Phosphate