Regular Article

British Journal of Cancer (2000) 83, 863–869. doi:10.1054/bjoc.2000.1389 www.bjcancer.com
Published online 5 September 2000

Fluorodeoxyglucose positron emission tomography in the evaluation of germ cell tumours at relapse

S F Hain1, M J O'Doherty1, A R Timothy2, M D Leslie2, P G Harper2 and R A Huddart3

  1. 1The Clinical PET Centre, Guy's and St Thomas' Hospitals, London, UK
  2. 2Department of Clinical Oncology, Guy's and St Thomas' Hospitals, London, UK
  3. 3The Royal Marsden Hospital, Surrey, UK

Received 21 January 2000; Revised 8 May 2000; Accepted 17 May 2000.

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Abstract

Differentiation of active disease from fibrosis/mature teratoma in patients with residual masses or identifying of sites of recurrence in patients with raised markers following treatment of their testicular cancer remains a problem.18F-fluorodeoxyglucose positron emission tomography (FDG-PET) has the potential to identify active disease and thereby influence further management in these patients. We performed a retrospective study of the use of FDG-PET in detecting residual/recurrent testicular carcinoma in 55 patients (seventy FDG-PET scans). Forty-seven scans were for the assessment of residual masses (18 had raised markers) and 23 scans were for the investigation of raised markers in the presence of normal CT scans. True positive results were based on positive histology or clinical follow-up. FDG-PET had a positive predictive value (PPV) of 96% and a negative predictive value (NPV) of 90% in patients with residual masses. This PPV was equivalent to that of markers (94%) but FDG-PET had the advantage of identifying the site of that recurrence. The NPV was higher than that of markers. In patients with raised markers alone the PPV of FDG-PET was 92% but the NPV was only 50%. However, subsequent FDG-PET imaging was frequently the first imaging modality to identify the site of disease. FDG-PET effected a management change in 57% of cases. FDG-PET scanning detected viable tumour in residual masses and identified sites of disease in suspected recurrence. © 2000 Cancer Research Campaign

Keywords:

fluorodeoxyglucose, positron emission tomography, testicular cancer

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