Diagnostic accuracy of integrated 18F-FDG PET/CT for restaging patients with malignant germ cell tumours

August 2014
British Journal of Radiology;Aug2014, Vol. 87 Issue 1040, p1
Academic Journal
Objective: Evaluation of utility of fluorine-18 fludeoxy-glucose (18F,-FDG) positron emission tomography/CT (PET/CT) for restaging patients with primary malignant germ cell tumours (GCTs). Methods: Data of 92 patients (age, 31.94 ±10.1 years; male/ female, 86/6) with histopatholpgically confirmed malignant GCTs (gonadal, 88; mediastinal, 4; seminomatous, 47 and non-seminomatdus, 45) who underwent 18F-FDG PET/CT for, restaging (suspected recurrence/post-therapy evaluation) were retrospectively analysed, Two experienced nuclear medicine physicians reviewed the PET/CT images in consensus, qualitatively and semi-quantitatively [maximum standardized, uptake value (SUVmax)]. Histopathology (if available), and clinical/imaging/biochemical follow-up (minimum of 6 months) were employed as the reference standard. Results: 18F:FDG PET/CT was interpreted as positive in 59 and negative in 33 patients. Local disease was seen in 5, nodal disease in 50 and distant metastasis in 22 patients. PET/CT was true positive in 49, false positive in 10, true negative in 30 and false negative in 3 patients. 18F-FDG PET/CT showed sensitivity, specificity,, positive predictive value, negative predictive value and accuracy of 94.2%, 75.0%, 83.0%, 90.9% and 85.8% overall; 90.0%, 74.0%; 72.0%, 90.9% and 80.8% in seminomatous GCT; and 96,8%, 76.9%, 91.1%, 90.9% and 91.1% in non-seminomatous GCT, respectively. Difference in PET/CT accuracy for seminomatous and non-seminomatous GCTs was not significant (p = 0.263). PET/CT demonstrated disease in 13 patients with negative/equivocal conventional imaging findings and in 9 patients with normal tumour markers. No site- or histology-based difference, Was seen in SUVmax. Conclusion: 18F-FDG PET/CT demonstrates high diagnostic accuracy for restaging patients with malignant GCTs. It has comparable diagnostic performance in both seminomatous and: non-seminomatous malignant GCTs. Advances in knowledge: The present article demonstrates high diagnostic accuracy 18F-FDG PET/CT for restaging both seminomatous and non-seminomatous malignant GCTs in a large patient population.


Related Articles

  • A Small Cell Carcinoma in the Testis Associated with Testicular Teratoma. Türkmen, Esma; Erdoğan, Bülent; Kodaz, Hilmi; Uzunoğlu, Sernaz // Balkan Medical Journal;Jun2014, Vol. 31 Issue 2, p191 

    The article discusses the case of a 44-year-old patient with painless testicular mass. The patient's medical history is explored as well as the results of his laboratory examinations that led to the diagnosis of metastatic small cell carcinoma (SmCc) of the testicle. Also tackled are SmCc's...

  • An unusual mature thyroid teratoma on CT and Tcm scintigraphy imaging in a child. Zhang, Yu-Zhen; Li, Wen-Hua; Zhu, Ming-Jie; Li, Yu-Hua; Gao, Yu // Pediatric Radiology;Nov2010, Vol. 40 Issue 11, p1831 

    We report the imaging findings of a mature thyroid teratoma in a 5-year-old girl. Nuclear imaging showed a decrease in Tcm uptake in the right lobe of the thyroid gland. CT scan showed a slightly lobulated soft-tissue mass without calcification, fat or cystic components. Histological analysis...

  • Fluorodeoxyglucose positron emission tomography in the evaluation of germ cell tumours at relapse. Hain, S F; O’Doherty, M J; Timothy, A R; Leslie, M D; Harper, P G; Huddart, R A; O'Doherty, M J // British Journal of Cancer;10/1/2000, Vol. 83 Issue 7, p863 

    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.(18)F-fluorodeoxyglucose positron emission tomography (FDG-PET)...

  • Metastatic Chordoma: Report of the Two Cases and Review of the Literature. Rohatgi, Saurabh; Ramaiya, Nikhil H.; Jagannathan, Jyothi P.; Howard, Stephanie A.; Shinagare, Atul B.; Krajewski, Katherine M. // Eurasian Journal of Medicine;Jun2015, Vol. 47 Issue 2, p151 

    Chordomas are rare malignant bone tumours with a predilection for the axial skeleton, especially the sacrum and skull base. Median survival in patients with metastatic disease is usually dismal. Treatment is challenging due to the propensity for local recurrence, metastatic disease as well as...

  • Diagnostic accuracy of preoperative alpha-fetoprotein as an ovarian tumor marker in children and adolescents: not as good as we thought? Loh, Amos; Gee, Kelvin; Chua, Joyce // Pediatric Surgery International;Jul2013, Vol. 29 Issue 7, p709 

    Purpose: To evaluate the diagnostic accuracy of preoperative serum alpha-fetoprotein (AFP) levels in predicting malignancy risk in children and adolescents presenting with ovarian neoplasms. Methods: In 110 girls aged 18 and below diagnosed with ovarian neoplasms, we retrospectively correlated...

  • A Cystic Mass does not Always Mean Hydatid Cyst in Endemic Areas. Yildiz, Abdullah; Oral, Akgun; Akin, Melih; Erginel, Basak; Karadag, Cetin Ali; Sever, Nihat; Dokucu, Ali Ihsan // Eurasian Journal of Medicine;Feb2014, Vol. 46 Issue 1, p64 

    Within the medical community, there is a tendency to describe all cystic lesions in the liver and lungs as Hydatid disease (HD) in areas with HD endemics. This approach may sometimes cause a misdi-agnosis. We have three cases with children aged between seven, seven and ten year old, all of whom...

  • Peripheral Primitive Neuroectodermal Tumor of the Pelvis. Yousefi, Zohreh; Sharifhi, Nourieh; Hasanzadeh, Malihe; Mottaghi, Mansoureh; Bolandy, Somayeh // Iranian Journal of Medical Sciences;Jan2014, Vol. 39 Issue 1, p71 

    The primitive neuroectodermal tumor (PNET) belongs to a group of highly malignant tumors and is composed of small round cells of a neuroectodermal origin. Categorized in the same tumor family as Ewing sarcoma, the PNET is most likely to occur in bones and soft tissues. However, a small number of...

  • Tumor markers in germ cell tumours. Rustin, Gordon J.S. // British Medical Journal (Clinical Research Edition);3/15/1986, Vol. 292 Issue 6522, p713 

    Evaluates the tumor markers on tumor diagnosed patients. Increase of serum concentration of human chorionic gonadotropin on patients with metastatic non-seminomatous germ cell tumors; Use of tumor markers for diagnostic aids and tumor development monitoring; Advantages on early diagnosis of tumors.

  • Chondronecrosis versus recurrence: FDG PET/CT solves the dilemma in a case of locally advanced laryngeal cancer treated with definitive radiotherapy. Puranik, Ameya D.; Purandare, Nilendu C.; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh // Indian Journal of Nuclear Medicine;Jul2013, Vol. 28 Issue 3, p191 

    A letter to the editor related to a case study of a 64-year-old gentleman was diagnose with fluorodeoxyglucose positron emission tomography/computed tomography (FDG) PET/CT for radiotherapy treated laryngeal cancer.


Read the Article

Courtesy of

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics