The role of [(18)F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management
Standard
The role of [(18)F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management. / Pfannenberg, Anna C; Oechsle, Karin; Bokemeyer, Carsten; Kollmannsberger, Christian; Dohmen, Bernhard M; Bares, Roland; Hartmann, Jörg T; Vonthein, Reinhard; Claussen, Claus D.
In: WORLD J UROL, Vol. 22, No. 2, 06.2004, p. 132-9.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - The role of [(18)F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management
AU - Pfannenberg, Anna C
AU - Oechsle, Karin
AU - Bokemeyer, Carsten
AU - Kollmannsberger, Christian
AU - Dohmen, Bernhard M
AU - Bares, Roland
AU - Hartmann, Jörg T
AU - Vonthein, Reinhard
AU - Claussen, Claus D
PY - 2004/6
Y1 - 2004/6
N2 - The purpose of this study was to assess the ability of [(18)F]FDG-PET, CT/MRI and serum tumor marker (TM) to predict the viability of residual masses after high-dose chemotherapy (HD-Ctx) in patients with metastatic germ cell tumors (GCT). In a prospective study, 60 residual tumors in 28 GCT patients were classified as viable/nonviable by FDG-PET, CT/MRI and TM levels. The results were validated either by histological examination of a resected mass and/or biopsy or by clinical/radiological follow-up for at least 6 months. There were no significant differences among the sensitivities observed with PET, CT/MRI and TM, but PET was significantly more specific than CT/MRI in predicting residual mass viability. TM showed the highest specificity. The highest accuracy in classification of residual tumors was achieved by a combination of PET, CT/MRI and TM (area under the ROC curve =0.91). All mature teratomas showed false-negative PET results with SUVs in the same range as necrosis. For classification of residual masses after HD-Ctx of metastatic GCT, [(18)F]FDG-PET is a valuable diagnostic method to complement the established procedures CT and TM. Positive PET results are highly correlated with the presence of viable tumor, but residual masses with negative PET findings still require resection. In cases of tumor progression diagnosed by CT and elevated TM, additional PET examinations are without benefit. PET seems useful in patients with stable disease or partial remission in CT/MRI and normalized TM as well as in marker-negative disease.
AB - The purpose of this study was to assess the ability of [(18)F]FDG-PET, CT/MRI and serum tumor marker (TM) to predict the viability of residual masses after high-dose chemotherapy (HD-Ctx) in patients with metastatic germ cell tumors (GCT). In a prospective study, 60 residual tumors in 28 GCT patients were classified as viable/nonviable by FDG-PET, CT/MRI and TM levels. The results were validated either by histological examination of a resected mass and/or biopsy or by clinical/radiological follow-up for at least 6 months. There were no significant differences among the sensitivities observed with PET, CT/MRI and TM, but PET was significantly more specific than CT/MRI in predicting residual mass viability. TM showed the highest specificity. The highest accuracy in classification of residual tumors was achieved by a combination of PET, CT/MRI and TM (area under the ROC curve =0.91). All mature teratomas showed false-negative PET results with SUVs in the same range as necrosis. For classification of residual masses after HD-Ctx of metastatic GCT, [(18)F]FDG-PET is a valuable diagnostic method to complement the established procedures CT and TM. Positive PET results are highly correlated with the presence of viable tumor, but residual masses with negative PET findings still require resection. In cases of tumor progression diagnosed by CT and elevated TM, additional PET examinations are without benefit. PET seems useful in patients with stable disease or partial remission in CT/MRI and normalized TM as well as in marker-negative disease.
KW - Adult
KW - Fluorodeoxyglucose F18
KW - Germinoma
KW - Humans
KW - Magnetic Resonance Imaging
KW - Middle Aged
KW - Neoplasm, Residual
KW - Positron-Emission Tomography
KW - Prospective Studies
KW - Radiopharmaceuticals
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Tomography, X-Ray Computed
KW - Tumor Markers, Biological
U2 - 10.1007/s00345-003-0392-6
DO - 10.1007/s00345-003-0392-6
M3 - SCORING: Journal article
C2 - 14735310
VL - 22
SP - 132
EP - 139
JO - WORLD J UROL
JF - WORLD J UROL
SN - 0724-4983
IS - 2
ER -