Cook Gary J, Sohaib Aslam, Huddart Robert A, Dearnaley David P, Horwich Alan, Chua Sue
aKings College London bRoyal Marsden NHS Foundation Trust, London cInstitute of Cancer Research, Sutton, Surrey, UK.
Nucl Med Commun. 2015 Jul;36(7):702-8. doi: 10.1097/MNM.0000000000000303.
The aim of this study was to determine the utility of fluorine-18 fluorodeoxyglucose PET/computed tomography ((18)F-FDG PET/CT) in managing testicular cancer.
Sixty-two patients (29 seminoma, 28 nonseminoma and five mixed) underwent 75 (18)F-FDG PET/CT scans (16 scans for primary staging, 44 for residual masses and 15 for rising tumour markers). Follow-up histology, clinical scans and tumour marker results were included for retrospective analysis.
(i) Primary staging: eight of 11 patients with equivocal CT scans had true-negative (18)F-FDG PET/CT scans. Five high-risk patients with normal stage 1 CT scans had negative (18)F-FDG PET/CT scans, but two subsequently relapsed. (ii) Residual masses: of the 20 scans interpreted as showing viable disease, five were false positive. Nineteen scans were negative (18 true negative and one false negative). (iii) Rising tumour markers: of the 15 scans, two were false negative and 13 were true positive.
(18)F-FDG PET/CT is helpful when primary staging CT scans are equivocal but insufficiently sensitive to predict relapse in high-risk patients with normal CT scans. With residual masses, a negative scan is rarely associated with relapse. (18)F-FDG PET/CT is helpful in defining recurrent disease in the majority of patients with rising tumour markers and negative CT scans.
本研究旨在确定氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（¹⁸F-FDG PET/CT）在睾丸癌管理中的效用。
62例患者（29例精原细胞瘤、28例非精原细胞瘤和5例混合型）接受了75次¹⁸F-FDG PET/CT扫描（16次用于初始分期，44次用于残留肿块评估，15次用于肿瘤标志物升高情况）。纳入随访组织学、临床扫描及肿瘤标志物结果进行回顾性分析。
（i）初始分期：11例CT扫描结果不明确的患者中，8例¹⁸F-FDG PET/CT扫描为真阴性。5例CT扫描显示为1期正常的高危患者¹⁸F-FDG PET/CT扫描为阴性，但其中2例随后复发。（ii）残留肿块：20次扫描结果显示为有活性病灶，其中5次为假阳性。19次扫描为阴性（18次真阴性和1次假阴性）。（iii）肿瘤标志物升高：15次扫描中，2次为假阴性，13次为真阳性。
当初始分期CT扫描结果不明确但对CT扫描正常的高危患者预测复发的敏感性不足时，¹⁸F-FDG PET/CT有帮助。对于残留肿块，扫描结果为阴性时很少与复发相关。¹⁸F-FDG PET/CT有助于确定大多数肿瘤标志物升高且CT扫描阴性患者的复发性疾病。
