Liang Cecilia, Sekler Julia, Gückel Brigitte, Pfannenberg Christina, Dittmann Helmut, Seith Ferdinand, Amend Bastian, Nikolaou Konstantin, Reinert Christian Philipp
Diagnostic and Interventional Radiology, Department of Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, University Hospital of Tuebingen, Otfried-Mueller-Strasse 14, 72076 Tübingen, Germany.
Cancers (Basel). 2023 Jul 17;15(14):3652. doi: 10.3390/cancers15143652.
The aim of this study was to evaluate the impact of PET/CT on clinical management of patients with germ cell tumors (GCTs) conducted in a real-world setting, including avoidance of invasive procedures, additional diagnostic imaging, and changes in treatment.
Patients with GCTs were prospectively enrolled into a PET/CT registry study between May 2013 and April 2021. Intended patient management prior and after PET/CT was documented using standardized questionnaires. Changes in oncologic staging and clinical management after PET/CT were recorded, including planned treatment and planned additional diagnostics.
Forty-three male patients with GCTs were included consecutively in this study. After PET/CT, oncologic staging changed in 22/43 patients (51%), with upstaging in seven cases (16%), downstaging in ten cases (23%), and cancer relapse in five cases (11%). The number of patients with intended curative treatment remained stable, while a considerable change in intended therapeutic intervention was noted after PET/CT, with an increase in planned chemotherapy from three to eleven patients and a decrease in planned surgical resection from eleven to two patients. In addition, PET/CT contributed to preventing patients from intended invasive procedures including biopsy and surgery in 8/43 (19%) cases and from additional diagnostic procedures in 25 (58%) cases.
With the use of FDG-PET/CT as a tool to guide patient management in GCTs, we observed a notable impact on clinical staging and a consequent reduction in the need for additional invasive and diagnostic procedures. These findings are expected to be even more consequential in the future as treatment modalities improve and the life expectancy of GCT patients further increases.
PET/CT considerably influences the clinical stage of GCT patients. PET/CT has remarkable influence on the choice of therapeutic interventions and reduces additional diagnostic procedures.
本研究旨在评估正电子发射断层显像/计算机断层扫描（PET/CT）在真实世界环境中对生殖细胞肿瘤（GCT）患者临床管理的影响，包括避免侵入性操作、额外的诊断性影像学检查以及治疗的改变。
2013年5月至2021年4月期间，GCT患者被前瞻性纳入PET/CT登记研究。使用标准化问卷记录PET/CT前后预期的患者管理情况。记录PET/CT后肿瘤分期和临床管理的变化，包括计划的治疗和计划的额外诊断。
本研究连续纳入了43例男性GCT患者。PET/CT后，43例患者中有22例（51%）肿瘤分期发生改变，其中7例（16%）分期上调，10例（23%）分期下调，5例（11%）癌症复发。预期进行根治性治疗的患者数量保持稳定，而PET/CT后预期的治疗干预有相当大的变化，计划化疗的患者从3例增加到11例，计划手术切除的患者从11例减少到2例。此外，PET/CT有助于避免43例中的8例（19%）患者进行包括活检和手术在内的预期侵入性操作，以及25例（58%）患者进行额外的诊断性操作。
使用氟脱氧葡萄糖-PET/CT作为指导GCT患者管理的工具，我们观察到其对临床分期有显著影响，并因此减少了对额外侵入性和诊断性操作的需求。随着治疗方式的改善和GCT患者预期寿命的进一步增加，这些发现预计在未来将产生更大的影响。
PET/CT对GCT患者的临床分期有很大影响。PET/CT对治疗干预的选择有显著影响，并减少了额外的诊断性操作。
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