title: 18F-FDG PET/CT impact on testicular tumours clinical management.
abstract: OBJECTIVE
  Testicular tumour is the most common malignancy in young men. The diagnostic work-up is mainly based on morphological imaging. The aim of our study was to evaluate the clinical impact of (18)F-FDG PET/CT in patients with testicular tumour.
  
  
  METHODS
  We retrospectively evaluated all patients studied by (18)F-FDG PET/CT at our centre. Inclusion criteria were: pathological confirmation of testicular tumour, contrast-enhanced CT scan performed within a month of the PET/CT scan, and clinical/imaging follow-up performed at the Oncology Unit of our hospital. Overall, 56 patients were enrolled and 121 PET/CT scans were evaluated. (18)F-FDG PET/CT was performed following standard procedures and the results were compared with clinical, imaging and follow-up data. Clinicians were contacted to inquire whether the PET/CT scan influenced the patient's management. Answers were scored as follows: start/continue chemotherapy or radiotherapy, indication for surgery of secondary lesions, and clinical surveillance.
  
  
  RESULTS
  On a scan basis, 51 seminoma and 70 nonseminoma (NS) cases were reviewed. Of the 121 cases. 32 were found to be true-positive, 74 true-negative, 8 false-positive and 6 false-negative by PET/CT. PET/CT showed good sensitivity and specificity for seminoma lesion detection (92% and 84%, respectively), but its sensitivity was lower for NS forms (sensitivity and specificity 77% and 95%, respectively). The PET/CT scan influenced the clinical management of 47 of 51 seminomas (in 6 chemotherapy was started/continued, in 3 radiotherapy was started/continued, in 2 surgery of secondary lesions was performed, and in 36 clinical surveillance was considered appropriate), and 59 of 70 NS (in 18 therapy/surgery was started/continued, and in 41 clinical surveillance was considered appropriate).
  
  
  CONCLUSIONS
  Our preliminary data demonstrate the potential usefulness of PET/CT for the assessment of patients with testicular tumour. It provides valuable information for the clinical management, particularly for clinical surveillance, post-therapy assessment and when relapse is suspected.
authors.affiliation: Nuclear Medicine, S.Orsola-Malpighi University Hospital, Via Massarenti 9, 40138, Bologna, Italy, valentina.ambrosini@aosp.bo.it.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ambrosini
authors.forename: Giorgia
authors.initials: G
authors.lastname: Zucchini
authors.forename: Silvia
authors.initials: S
authors.lastname: Nicolini
authors.forename: Annalisa
authors.initials: A
authors.lastname: Berselli
authors.forename: Cristina
authors.initials: C
authors.lastname: Nanni
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Allegri
authors.forename: Andrea
authors.initials: A
authors.lastname: Martoni
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Rubello
authors.initials: R
authors.lastname: Domenico
authors.forename: Antonia
authors.initials: A
authors.lastname: Cricca
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D018239:Seminoma / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18