title: Can we rely on PET in the follow-up of advanced seminoma patients?
abstract: The management of residuals after completion of chemotherapy in advanced seminoma is controversial. It has been proposed that fluorodeoxyglucose-positron emission tomography (FDG-PET) can be used as a follow-up. In this study we investigated FDG-PET as a follow-up tool in advanced seminoma patients treated previously with chemotherapy or radiotherapy. Thirty-seven patients assigned to an advanced seminoma group based on CT and/or FDG-PET/CT and then treated with chemotherapy were included in the study. All these patients underwent FDG-PET/CT examination as a part of the follow-up scheme. Patients underwent retroperitoneal lymph node dissection (RPLND), radiotherapy, or were followed clinically by CT and/or PET/CT every 6 months. In 8 cases FDG-PET was positive: 5 of them underwent RPLND and 3 radiotherapy. Two patients with negative FDG-PET but positive CT also underwent RPLND. The remaining patients with negative FDG-PET results were followed up. FDG-PET/CT was false positive in one case >3 cm and one <3 cm, in 6 cases >3 cm it was true negative. While FDG-PET can find a viable tumor, there also is an important question of false positive results. It was clinically proven that a negative FDG-PET was correlated with stable disease, but we were unable to examine specimens in these cases.
authors.affiliation: Department of Urology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Siekiera
authors.forename: Bogdan
authors.initials: B
authors.lastname: Małkowski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jóźwicki
authors.forename: Miłosz
authors.initials: M
authors.lastname: Jasiński
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wronczewski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Pietrzak
authors.forename: Ewa
authors.initials: E
authors.lastname: Chmielowska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Petrus
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kamecki
authors.forename: Witold
authors.initials: W
authors.lastname: Mikołajczak
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kraśnicki
authors.forename: Piotr
authors.initials: P
authors.lastname: Chłosta
authors.forename: Tomasz
authors.initials: T
authors.lastname: Drewa
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005189:False Positive Reactions; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D064847:Multimodal Imaging; D018365:Neoplasm, Residual; D011044:Poland; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018239:Seminoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18