2-¹⁸fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) has been recommended
in international guidelines in the evaluation of postchemotherapy seminoma residuals.
Our trial was designed to validate these recommendations in a larger group of patients.
FDG-PET studies in patients with metastatic seminoma and residual masses after platinum-containing
chemotherapy were correlated with either the histology of the resected lesion(s) or
the clinical outcome.
One hundred and seventy seven FDG-PET results were contributed. Of 127 eligible PET
studies, 69% were true negative, 11% true positive, 6% false negative, and 15% false
positive. We compared PET scans carried out before and after a cut-off level of 6
weeks after the end of the last chemotherapy cycle. PET sensitivity, specificity,
negative predictive value (NPV), and positive predictive value were 50%, 77%, 91%,
and 25%, respectively, before the cut-off and 82%, 90%, 95%, and 69% after the cut-off.
PET accuracy significantly improved from 73% before to 88% after the cut-off (P=0.032).
Our study confirms the high specificity, sensitivity, and NPV of FDG-PET for evaluating
postchemotherapy seminoma residuals. When carried out at an adequate time point, FDG-PET
remains a valuable tool for clinical decision-making in this clinical setting and
spares patients unnecessary therapy.