Positron emission tomography and histology of residual postchemotherapy masses in patients with nonseminomatous germ cell tumours
Authors:
Jana Grimová 1*; Tomáš Büchler 1*; Pavel Fencl 2; Kateřina Šimonová 2; Zuzana Donátová 1; Ludmila Boublíková 1; Martin Kupec 1; Jaroslav Jarabák 3; Roman Zachoval 3; Jitka Abrahámová 1
Authors place of work:
Onkologická klinika Thomayerovy nemocnice a 1. lékařské fakulty Univerzity Karlovy, Praha
1; Oddělení nukleární medicíny a PET centrum, Nemocnice Na Homolce, Praha
2; Urologické oddělení Thomayerovy nemocnice, Praha
3
Published in the journal:
Ces Urol 2012; 16(1): 43-49
Category:
Original article
*přispěli stejným dílem
Summary
Aim:
The value of using fluorodeoxyglucose positron emission tomography (FDG-PET) before residual mass resection was studied in patients with nonseminomatous germ cell tumours (NSGCTs) after orchiectomy and platinumbased chemotherapy.
Methods:
Thirty patients with NSGCTs who had been investigated with FDG-PET in the preoperative period were evaluated retrospectively. We have calculated specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of FDG-PET to correctly predictt he presence of viable carcinoma, mature teratoma,and necrotic/ scar tissue in postchemotherapy residual masses.
Results:
FDG-PET was evaluated as negative, positive, or inconclusive in 11 (37%), 17 (57%) and 2 (7%) patients, respectively. Histological examination of the resected residual masses showed immature tumour elements, mature teratoma, and no tumour structures in 12 (40%), 11 (37%), and 7(23%) patients, respectively. FDG-PET correctly identified only 50% of lesions with immature tumour elements. FDG-PET was negative in 13/21 (62%) patients with immature elements and/or mature teratoma – histologies that require surgical resection because of high risk of relapse.
Conclusions:
Sensitivity, specificity, PPV, and NPV of FDGPET were insufficient for characterisation of postchemotherapy residual lesions in NSGCT patients. These residual masses should be resected if technically possible regardless of the FDG-PET result.
Key words:
positron emission tomography, testicular cancer, therapy.
Zdroje
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Štítky
Paediatric urologist Nephrology UrologyČlánok vyšiel v časopise
Czech Urology
2012 Číslo 1
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