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2-¹⁸fluoro-deoxy-D-glucose Positron Emission Tomography Is a Reliable Predictor for Viable Tumor in Postchemotherapy Seminoma: An Update of the Prospective Multicentric SEMPET Trial

From the Departments of Medical Oncology, Surgery and Ludwig Boltzmann Institute for Applied Cancer Research, Kaiser Franz Josef Spital; Department of Nuclear Medicine, University of Vienna Medical School, Vienna; Austrian Study Group on Urologic Oncology, Landeskrankenhaus Feldkirch, Austria; and the Department of Medical Oncology and Institute of Nuclear Medicine, University of Tübingen, Tübingen, Germany.

Address reprint requests to Jörg Pont, MD, 3 Medizinische Abteilung mit Onkologie, Kaiser Franz Josef Spital, Kundratstrasse 3, A-1100 Wien, Austria; e-mail: joerg.pont{at}univie.ac.at

PURPOSE: To define the clinical value of 2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG PET) as a predictor for viable residual tumor in postchemotherapy seminoma residuals in a prospective multicentric trial.

PATIENTS AND METHODS: FDG PET studies in patients with metastatic pure seminoma who had radiographically defined postchemotherapy residual masses were correlated with either the histology of the resected lesion or the clinical outcome documented by computer tomography (CT), tumor markers, and/or physical examination during follow-up. The size of the residual lesions on CT, either > 3 cm or 3 cm, was correlated with the presence or absence of viable residual tumor.

RESULTS: Fifty-six FDG PET scans of 51 patients were assessable. All 19 cases with residual lesions > 3 cm and 35 (95%) of 37 with residual lesions 3 cm were correctly predicted by FDG PET. The specificity, sensitivity, positive predictive value, and negative predictive value of FDG PET were 100% (95% CI, 92% to 100%), 80% (95% CI, 44% to 95%), 100%, and 96%, respectively, versus 74% (95% CI, 58% to 85%), 70% (95% CI, 34% to 90%), 37%, and 92%, respectively, for CT discrimination of the residual tumor by size (> 3 cm/ 3 cm).

CONCLUSION: This investigation confirms that FDG PET is the best predictor of viable residual tumor in postchemotherapy seminoma residuals and should be used as a standard tool for clinical decision making in this patient group.

These data were presented in part at the 39th Annual Meeting of the American Society of Clinical Oncology, Chicago IL, May 31-June 3, 2003, and at the 50th Annual Meeting of the Society of Nuclear Medicine, New Orleans, LA, June 21-25, 2003.

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

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