TITLE

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

AUTHOR(S)
SHARMA, P.; JAIN, T. K.; PARIDA, G. K.; KARUNANITHI, S.; PATEL, C.; SHARMA, A.; THULKAR, S.; JULKA, P. K.; BAL, C.; KUMAR, R.
PUB. DATE
August 2014
SOURCE
British Journal of Radiology;Aug2014, Vol. 87 Issue 1040, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
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.
ACCESSION #
97482427

 

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