title: The impact of systemic chemotherapy on testicular FDG activity in young men with Hodgkin's lymphoma.
abstract: OBJECTIVE
  Based on prior reports suggesting a positive correlation between fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/CT and total sperm count and concentration, we sought to identify changes in testicular FDG uptake over the course of chemotherapy in young men with Hodgkin's lymphoma.
  
  
  METHODS
  Fifty-two patients with a mean age of 24.2 years (range 15.5-44.4) at diagnosis monitored with FDG PET/CT to assess treatment response for Hodgkin's lymphoma were selected for this retrospective analysis under an Institutional Review Board waiver. Of the patients, 26 were treated with a chemotherapy regimen known to cause prolonged and sometimes permanent azoospermia (BEACOPP--bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) and 26 with a regimen known to have a much milder effect on gonadal function (ABVD--doxorubicin, bleomycin, vincristine, and dacarbazine). Each patient underwent one FDG PET/CT before treatment and at least one FDG PET/CT after start of chemotherapy. In all examinations, FDG activity was measured in the testes with different quantification metrics: maximum standardized uptake value (SUVmax), SUVmean, functional volume (FV) and total testicular glycolysis (TTG), and blood pool activity determined (SUVmean).
  
  
  RESULTS
  Testicular FDG uptake (SUVmax) was significantly associated with blood pool activity (p < 0.001). Furthermore, testicular FDG uptake metrics incorporating volume (e.g., FV and TTG) were associated with age. There was no significant change in SUVmax, SUVmean, FV, and TTG from the PET/CT at baseline to the PET/CTs over the course of chemotherapy either for patients treated with BEACOPP or for patients treated with ABVD.
  
  
  CONCLUSIONS
  For patients undergoing chemotherapy for Hodgkin's lymphoma, there is a significant association between testicular FDG uptake and blood pool activity, but no significant changes in FDG uptake over the course of chemotherapy. Therefore, FDG uptake may not be a feasible surrogate marker for fertility monitoring in patients with Hodgkin's lymphoma undergoing chemotherapy.
authors: Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA.
authors: Irene A
authors: IA
authors: Burger
authors: Hebert Alberto
authors: HA
authors: Vargas
authors: Debra A
authors: DA
authors: Goldman
authors: Mithat
authors: M
authors: Gonen
authors: Anita
authors: A
authors: Kumar
authors: Andrew D
authors: AD
authors: Zelenetz
authors: Heiko
authors: H
authors: Schöder
authors: Hedvig
authors: H
authors: Hricak
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D001692:Biological Transport; D001761:Bleomycin; D003520:Cyclophosphamide; D003606:Dacarbazine; D004317:Doxorubicin; D005047:Etoposide; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011241:Prednisone; D011344:Procarbazine; D012189:Retrospective Studies; D013076:Sperm Count; D013737:Testis / Q000187:drug effects* / Q000378:metabolism* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014747:Vinblastine; D014750:Vincristine; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18; D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D003606:Dacarbazine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
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