Positronenemissionstomographie bei Keimzelltumoren des Mannes: Einsatzmöglichkeiten und Grenzen
Standard
Positronenemissionstomographie bei Keimzelltumoren des Mannes: Einsatzmöglichkeiten und Grenzen. / Schriefer, P; Hartmann, M; Oechsle, K; Meyer, C P; Klutmann, S; Fisch, M; Bokemeyer, C; Oing, C.
In: UROLOGE, Vol. 58, No. 4, 04.2019, p. 418-423.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Positronenemissionstomographie bei Keimzelltumoren des Mannes: Einsatzmöglichkeiten und Grenzen
AU - Schriefer, P
AU - Hartmann, M
AU - Oechsle, K
AU - Meyer, C P
AU - Klutmann, S
AU - Fisch, M
AU - Bokemeyer, C
AU - Oing, C
PY - 2019/4
Y1 - 2019/4
N2 - BACKGROUND: Conventional radiographic imaging may fail to safely distinguish clinical stage I from stage IIA germ cell cancer, to localize isolated tumor marker relapses, and to equivocally identify the viability of postchemotherapy residual masses.OBJECTIVES: To provide an overview of the diagnostic value and limitations of functional imaging by positron emission tomography with 2‑deoxy-2-[fluorine-18]fluoro-D-glucose with computed tomography (18F-FDG-PET-CT) in male germ cell cancer.MATERIALS AND METHODS: A narrative review based on a literature search of PubMed/MEDLINE for original articles published from 1990-2018 and conference proceedings of ASCO (American Society of Clinical Oncology) and EAU (European Association of Urology) annual meetings 2014-2017 is presented.RESULTS: 18F-FDG-PET-CT does not improve diagnostic accuracy compared to conventional CT imaging clinical stage (CS) I disease. Particularly PET-negativity of postchemotherapy residual masses of seminomas >3 cm in size guide decision-making against further additional treatment. Even PET-positive residues must not result in relapse. For nonseminoma, the value of PET imaging is reduced by potential mature teratoma components, which are commonly PET negative.CONCLUSIONS: Current guidelines recommend 18F-FDG-PET-CT 6-8 weeks postchemotherapy for viability assessment of seminoma residues >3 cm in size. Exceptional circumstances, in which 18F-FDG-PET-CT may be helpful, include: (1) detection of active disease in CS IS, (2) viability assessment of residual masses >1 cm where complete secondary resection is impossible, (3) staging at marker relapse with unconspicuous conventional CT scan, (4) early response assessment during chemotherapy.
AB - BACKGROUND: Conventional radiographic imaging may fail to safely distinguish clinical stage I from stage IIA germ cell cancer, to localize isolated tumor marker relapses, and to equivocally identify the viability of postchemotherapy residual masses.OBJECTIVES: To provide an overview of the diagnostic value and limitations of functional imaging by positron emission tomography with 2‑deoxy-2-[fluorine-18]fluoro-D-glucose with computed tomography (18F-FDG-PET-CT) in male germ cell cancer.MATERIALS AND METHODS: A narrative review based on a literature search of PubMed/MEDLINE for original articles published from 1990-2018 and conference proceedings of ASCO (American Society of Clinical Oncology) and EAU (European Association of Urology) annual meetings 2014-2017 is presented.RESULTS: 18F-FDG-PET-CT does not improve diagnostic accuracy compared to conventional CT imaging clinical stage (CS) I disease. Particularly PET-negativity of postchemotherapy residual masses of seminomas >3 cm in size guide decision-making against further additional treatment. Even PET-positive residues must not result in relapse. For nonseminoma, the value of PET imaging is reduced by potential mature teratoma components, which are commonly PET negative.CONCLUSIONS: Current guidelines recommend 18F-FDG-PET-CT 6-8 weeks postchemotherapy for viability assessment of seminoma residues >3 cm in size. Exceptional circumstances, in which 18F-FDG-PET-CT may be helpful, include: (1) detection of active disease in CS IS, (2) viability assessment of residual masses >1 cm where complete secondary resection is impossible, (3) staging at marker relapse with unconspicuous conventional CT scan, (4) early response assessment during chemotherapy.
KW - English Abstract
KW - Journal Article
KW - Review
U2 - 10.1007/s00120-018-0797-x
DO - 10.1007/s00120-018-0797-x
M3 - SCORING: Review
C2 - 30374517
VL - 58
SP - 418
EP - 423
JO - UROLOGE
JF - UROLOGE
SN - 0340-2592
IS - 4
ER -