Positron emission tomography evaluation of residual radiographic abnormalities in postchemotherapy germ cell tumor patients

A. W. Stephens, R. Gonin, G. D. Hutchins, L. H. Einhorn

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Abstract

Purpose: This study was performed to assess the ability of positron emission tomography (PET) to differentiate residual radiographic abnormalities in postchemotherapy nonseminomatous germ cell tumor (GCT) patients. Materials and Methods: Thirty patients with nonseminomatous GCT were evaluated with PET scans before surgical resection of a residual mass or masses. Standardized uptake values (SUV) were calculated for the region of maximal 2-fluoro-2-deoxyglucose (FDG) uptake and compared with histologic findings. Results: Eleven patients had necrosis/fibrosis in the resected specimen, 15 had teratoma, and four viable GCT. The median SUV for the necrosis/fibrosis group was 2.86, teratoma 3.07, and viable GCT 8.81. A significant association between SUV and histology was found when comparing viable GCT versus necrosis/fibrosis plus teratoma (P = .004). Patients with an SUV greater than 5 were 75 times more likely to have viable cancer than teratoma or necrosis/fibrosis (odds ratio; 95% confidence interval, 3.66 to 1,536). PET did not differentiate necrosis/fibrosis from teratoma. However, PET was able to differentiate viable GCT from residual necrosis/fibrosis or teratoma. Conclusion: PET-FDG imaging can be useful for detection of residual viable carcinoma following chemotherapy in nonseminomatous GCT patients with residual masses. It may be a valuable adjunct in the determination of which patients should undergo postchemotherapy resection.

Original languageEnglish (US)
Pages (from-to)1637-1641
Number of pages5
JournalJournal of Clinical Oncology
Volume14
Issue number5
DOIs
StatePublished - May 1996

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Germ Cell and Embryonal Neoplasms
Teratoma
Positron-Emission Tomography
Fibrosis
Necrosis
Fluorodeoxyglucose F18
Histology
Odds Ratio
Confidence Intervals
Carcinoma
Drug Therapy
Nonseminomatous germ cell tumor
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Positron emission tomography evaluation of residual radiographic abnormalities in postchemotherapy germ cell tumor patients. / Stephens, A. W.; Gonin, R.; Hutchins, G. D.; Einhorn, L. H.

In: Journal of Clinical Oncology, Vol. 14, No. 5, 05.1996, p. 1637-1641.

Research output: Contribution to journalArticle

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abstract = "Purpose: This study was performed to assess the ability of positron emission tomography (PET) to differentiate residual radiographic abnormalities in postchemotherapy nonseminomatous germ cell tumor (GCT) patients. Materials and Methods: Thirty patients with nonseminomatous GCT were evaluated with PET scans before surgical resection of a residual mass or masses. Standardized uptake values (SUV) were calculated for the region of maximal 2-fluoro-2-deoxyglucose (FDG) uptake and compared with histologic findings. Results: Eleven patients had necrosis/fibrosis in the resected specimen, 15 had teratoma, and four viable GCT. The median SUV for the necrosis/fibrosis group was 2.86, teratoma 3.07, and viable GCT 8.81. A significant association between SUV and histology was found when comparing viable GCT versus necrosis/fibrosis plus teratoma (P = .004). Patients with an SUV greater than 5 were 75 times more likely to have viable cancer than teratoma or necrosis/fibrosis (odds ratio; 95{\%} confidence interval, 3.66 to 1,536). PET did not differentiate necrosis/fibrosis from teratoma. However, PET was able to differentiate viable GCT from residual necrosis/fibrosis or teratoma. Conclusion: PET-FDG imaging can be useful for detection of residual viable carcinoma following chemotherapy in nonseminomatous GCT patients with residual masses. It may be a valuable adjunct in the determination of which patients should undergo postchemotherapy resection.",
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