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Urso L, Bauckneht M, Albano D, Chondrogiannis S, Grassetto G, Lanfranchi F, Dondi F, Fornarini G, Lazzeri M, Evangelista L. The evolution of PET imaging in renal, bladder, upper urinary tract urothelial, testicular and penile carcinoma - Today's impact, tomorrow's potential. Expert Rev Med Devices 2024; 21:55-72. [PMID: 38072680 DOI: 10.1080/17434440.2023.2293919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/07/2023] [Indexed: 02/05/2024]
Abstract
INTRODUCTION The advancement of hybrid PET/CT or PET/MRI imaging for non-prostate genitourinary cancers has not experienced the rapid progress of prostate cancer. Nevertheless, these neoplasms are aggressive and reliable imaging plays a pivotal role in enhancing patients' quality of life and prognosis. AREAS COVERED the main evidence regarding [18F]FDG and non-[18F]FDG PET/CT or PET/MRI in non-prostate uro-oncological malignancies are summarized and discussed. Moreover, potential future directions concerning PET imaging in these neoplasms are debated, with the aim to stimulate future research projects covering these fields. EXPERT OPINION In Renal Cell Carcinoma (RCC), [18F]FDG PET/CT demonstrates varying efficacy in staging, restaging, and prognostic stratification, but PSMA PET/CT is emerging as a potential game-changer, particularly in advanced, high-grade aggressive clear cell RCC. [18F]FDG PET/CT may see an increased use in N and M-staging of bladder cancer, as well as for detecting recurrence and response to neoadjuvant chemotherapy. Preliminary data regarding [68Ga]-FAPI also looks promising in this context. [18F]FDG PET/MRI could be useful for the T-staging of bladder cancer, while upper tract urothelial carcinoma still lacks of molecular imaging literature reports. In testicular and penile cancer [18F]FDG PET/CT has demonstrated its usefulness in several clinical settings, although experiences with non-[18F]FDG radiotracers are lacking.
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Affiliation(s)
- Luca Urso
- Department of Nuclear Medicine - PET/CT Center, S. Maria Della Misericordia Hospital, Rovigo, Italy
| | - Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Domenico Albano
- Nuclear Medicine Department, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Sotirios Chondrogiannis
- Department of Nuclear Medicine - PET/CT Center, S. Maria Della Misericordia Hospital, Rovigo, Italy
| | - Gaia Grassetto
- Department of Nuclear Medicine - PET/CT Center, S. Maria Della Misericordia Hospital, Rovigo, Italy
| | - Francesco Lanfranchi
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Francesco Dondi
- Nuclear Medicine Department, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Laura Evangelista
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
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Ghosh S, Agrawal A, Rangarajan V, Choudhury S, Maitre P, Purandare N, Shah S, Puranik A, Bakshi G, Joshi A, Prakash G, Menon S, Prabhash K, Norohna V, Pal M, Murthy V. Evaluation of post-chemotherapy residual seminomatous masses by 18F-fluorodeoxyglucose PET/CT using tumor-to-liver ratio - conundrum or solution? Nucl Med Commun 2023; 44:1156-1162. [PMID: 37706256 DOI: 10.1097/mnm.0000000000001762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
OBJECTIVE Assessment of diagnostic accuracy of FDG-PET/CT in the detection of viable disease in post-chemotherapy seminomatous residual masses using visual interpretation, SUVmax, and T/L ratio. METHODS This is a retrospective study assessing the post-chemotherapy seminomatous residual masses of size >3 cm. The PET/CT scan findings were interpreted visually for presence of residual disease which were validated from histopathology reports or imaging follow-up for a maximum of 3 years. SUVmax and T/L ratios were also determined for all the residual lesions. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value NPV were calculated and compared for all three parameters along with ROC analysis to obtain an optimal cutoff value for SUVmax and T/L ratio, respectively. RESULTS Sample size was 49. Out of these 49 patients, 8 had validation of PET results with histopathology. Rest was validated with imaging follow-up. FDG-PET was positive in 30 patients and negative in 19 patients by visual interpretation. The sensitivity, specificity, PPV, and NPV by this method were 100%, 62.5%, 73%, and 100%, respectively. The SUVmax and T/L ratios were also calculated for these lesions. The cutoff for these two variables was 4.56 and 1.21, respectively. The sensitivity, specificity, PPV, and NPV at these cutoffs were 76%, 87.5%, 86%, 77.7%, and 92%, 87.5%, 88%, 91%, respectively. CONCLUSION FDG-PET has a favorable diagnostic value in predicting viable disease in post-chemotherapy seminomatous residual masses and using T/L ratio cutoff of 1.21 will increase the specificity of the test.
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Affiliation(s)
- Suchismita Ghosh
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Archi Agrawal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Sayak Choudhury
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Priyamvada Maitre
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Nilendu Purandare
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Sneha Shah
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Ameya Puranik
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Ganesh Bakshi
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute and
| | - Gagan Prakash
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute and
| | - Vanita Norohna
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute and
| | - Mahendra Pal
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute,
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute,
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Woo I, Cho SJ, Park CH. State-of-the-art update for diagnosing diabetic foot osteomyelitis: a narrative review. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2023; 40:321-327. [PMID: 37822082 PMCID: PMC10626300 DOI: 10.12701/jyms.2023.00976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using "diabetic foot [MeSH]" and "osteomyelitis [MeSH]" or "diagnosis" was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.
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Affiliation(s)
- Inha Woo
- Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Korea
| | - Seung Jae Cho
- Department of Orthopaedic Surgery, Yeungnam University Hospital, Daegu, Korea
| | - Chul Hyun Park
- Department of Orthopaedic Surgery, Yeungnam University College of Medicine, Daegu, Korea
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Liang C, Sekler J, Gückel B, Pfannenberg C, Dittmann H, Seith F, Amend B, Nikolaou K, Reinert CP. How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World. Cancers (Basel) 2023; 15:3652. [PMID: 37509313 PMCID: PMC10377569 DOI: 10.3390/cancers15143652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/09/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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. CONCLUSION 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. KEY POINTS 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.
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Affiliation(s)
- Cecilia Liang
- Diagnostic and Interventional Radiology, Department of Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Julia Sekler
- 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
| | - Brigitte Gückel
- 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
| | - Christina Pfannenberg
- Diagnostic and Interventional Radiology, Department of Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Helmut Dittmann
- Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, University Hospital of Tuebingen, Otfried-Mueller-Strasse 14, 72076 Tübingen, Germany
| | - Ferdinand Seith
- Diagnostic and Interventional Radiology, Department of Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Bastian Amend
- Department of Urology, Tübingen University Hospital, 72076 Tübingen, Germany
| | - Konstantin Nikolaou
- Diagnostic and Interventional Radiology, Department of Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies", University of Tübingen, 72076 Tübingen, Germany
- German Cancer Consortium (DKTK), Partner Site Tübingen, 72076 Tübingen, Germany
| | - Christian Philipp Reinert
- Diagnostic and Interventional Radiology, Department of Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
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Wood GE, Chamberlain F, Tran B, Conduit C, Liow E, Nicol DL, Shamash J, Alifrangis C, Rajan P. Treatment de-escalation for stage II seminoma. Nat Rev Urol 2023:10.1038/s41585-023-00727-0. [PMID: 36882564 DOI: 10.1038/s41585-023-00727-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/09/2023]
Abstract
International Germ Cell Cancer Collaborative Group good-risk metastatic seminoma has cure rates of >95%. Within this risk group, patients with stage II disease exhibit the best oncological outcomes with the standard-of-care treatment strategies of radiotherapy or combination chemotherapy. However, these treatments can be associated with substantial early and late toxic effects. Therapy de-escalation aims to reduce treatment morbidity whilst preserving oncological outcomes. The evidence supporting such approaches is largely from non-randomized institutional data, and therefore this strategy is not recognized as standard of care. Current de-escalation approaches for stage II seminoma include single-agent chemotherapy, radiotherapy and surgery based on early data from clinical studies. Increased recognition of emerging data on treatment modification to reduce morbidity whilst maintaining cure rates and consideration of therapy de-escalation could improve patient survivorship outcomes.
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Affiliation(s)
- Georgina E Wood
- Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK.,Department of Medical Oncology, Barts Health NHS Trust, London, UK
| | | | - Ben Tran
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Division of Personalized Medicine, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Ciara Conduit
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Division of Personalized Medicine, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Elizabeth Liow
- Division of Personalized Medicine, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - David L Nicol
- Department of Urology, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Jonathan Shamash
- Department of Medical Oncology, Barts Health NHS Trust, London, UK
| | - Constantine Alifrangis
- Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK. .,National Institute for Health Research University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
| | - Prabhakar Rajan
- Centre for Cancer Cell and Molecular Biology, Barts Cancer Institute, Queen Mary University of London, London, UK. .,Division of Surgery and Interventional Science, University College London, London, UK. .,Department of Urology, Barts Health NHS Trust, London, UK. .,Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
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Haj-Mirzaian A, Mahmood U, Heidari P. Targeted Molecular Imaging as a Biomarker in Urologic Oncology. Urol Clin North Am 2023; 50:115-131. [PMID: 36424076 PMCID: PMC10133841 DOI: 10.1016/j.ucl.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Urologic malignancies constitute a large portion of annually diagnosed cancers. Timely diagnosis, accurate staging, and assessment of tumor heterogeneity are essential to devising the best treatment strategy for individual patients. The high sensitivity of molecular imaging allows for early and sensitive detection of lesions that were not readily detectable using conventional imaging techniques. Moreover, molecular imaging enables the interrogation of molecular processes used in targeted cancer therapies and predicts cancer response to treatment. Here we review the current advancements in molecular imaging of urologic cancers, including prostatic, vesical, renal testicular, and ureteral cancers.
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Affiliation(s)
- Arvin Haj-Mirzaian
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA; Center for Precision Imaging, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA
| | - Umar Mahmood
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA; Center for Precision Imaging, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA.
| | - Pedram Heidari
- Department of Radiology, Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA; Center for Precision Imaging, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit St, Wht 427, Boston, MA 02114, USA
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The Importance of Repeat Imaging Prior to Treatment Decision-making in Testicular Cancer: Commentary From the Inaugural Global Society of Rare Genitourinary Tumors Summit. Clin Genitourin Cancer 2022; 21:418.e1-418.e6. [PMID: 36624008 DOI: 10.1016/j.clgc.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
Testicular cancer is a rare cancer that often affects young and otherwise healthy patients. Imaging plays a critical role in the staging and surveillance of patients with testicular cancer. Indeterminate findings on staging or surveillance imaging, can lead to challenging management decisions for clinicians and patients. In this article, we review the importance of short-interval, repeat imaging for several scenarios faced by patients with testicular cancer and their clinicians. The challenging scenarios and recommendations provided in this article summarize the discussion from the inaugural Global Society of Rare Genitourinary Tumors (GSRGT) Summit held on December 11-12, 2020.
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Abstract
Testicular cancer is a curable cancer. The success of physicians in curing the disease is underpinned by multidisciplinary advances. Cisplatin-based combination chemotherapy and the refinement of post-chemotherapy surgical procedures and diagnostic strategies have greatly improved long term survival in most patients. Despite such excellent outcomes, several controversial dilemmas exist in the approaches to clinical stage I disease, salvage chemotherapy, post-chemotherapy surgical procedures, and implementing innovative imaging studies. Relapse after salvage chemotherapy has a poor prognosis and the optimal treatment is not apparent. Recent research has provided insight into the molecular mechanisms underlying cisplatin resistance. Phase 2 studies with targeted agents have failed to show adequate efficacy; however, our understanding of cisplatin resistant disease is rapidly expanding. This review summarizes recent advances and discusses relevant issues in the biology and management of testicular cancer.
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Affiliation(s)
- Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, National Cancer Institute, Bratislava, Slovakia
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Lifespan Academic Medical Center, Providence, RI, USA
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Murez T, Fléchon A, Branger N, Savoie PH, Rocher L, Camparo P, Neuville P, Ferretti L, Van Hove A, Roupret M. French AFU Cancer Committee Guidelines - Update 2022-2024: testicular germ cell cancer. Prog Urol 2022; 32:1066-1101. [DOI: 10.1016/j.purol.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022]
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Joel A, Singh A, Hepzibah J, Devasia A, Kumar S, Gnanamuthu BR, Chandramohan A, George AJP, John NT, Yadav B, John AO, Georgy JT, John S, Chacko RT. End-of-Treatment FDG PET-CT (EOT-PET) in Patients with Post-Chemotherapy Masses for Seminoma: Can We Avoid Further Intervention? South Asian J Cancer 2022; 11:315-321. [PMID: 36756102 PMCID: PMC9902077 DOI: 10.1055/s-0041-1735480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Anjana JoelContext Patients with seminoma present with advanced disease. End-of-treatment (EOT) positron emission tomography-computed tomography (PET-CT) is done to assess response and direct management of post-chemotherapy residual masses. Purpose This article assesses the utility of EOT PET-CT in the management of post-chemotherapy residual lymph nodal masses seminoma. Materials and Methods We analyzed all patients with seminoma who underwent an EOT PET-CT from January 2015 to January 2020 at our center and calculated the positive predictive value (PPV) and negative predictive value (NPV) of EOT PET-CT in the entire cohort of patients and among subgroups. Results A total of 34 male patients underwent EOT PET-CT. Fourteen (41.2%) were stratified as good risk and 20 (58.8%) as intermediate risk. The median follow-up was 23 months (interquartile range: 9.75-53 months). In 23 patients there were residual masses of size more than 3 cm at the EOT PET scan. EOT PET was positive as per the SEMPET criteria in 18 (78%) out of 23 patients. None underwent retroperitoneal lymph node dissection. All four who underwent image-guided biopsy, showed only necrosis on pathology. One patient with positive mediastinal node (standardized uptake value 13.6) had granulomatous inflammation. There was no relapse or progression during this period of follow-up. The NPV for EOT PET-CT for the entire cohort, > 3 cm, and > 6 weeks cutoff were 100%, respectively. The PPV for EOT PET-CT for the entire cohort, > 3 cm residual mass, and > 6 weeks cutoff were 8.7, 11.11, and 6.67%, respectively. Conclusion EOT PET-CT has a low PPV and high NPV in predicting viable tumor in post-chemotherapy residual masses among patients with seminomatous germ cell tumors. If required, EOT PET positivity can be confirmed by a biopsy or reassessed with a repeat PET-CT imaging to document persistent disease prior to further intervention.
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Affiliation(s)
- Anjana Joel
- Department of Medical Oncology, Christian Medical College (CMC), Vellore, Tamil Nadu, India,Address for correspondence Anjana Joel, MD, DM Department of Medical Oncology Christian Medical College and HospitalVellore, Tamil NaduIndia
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Julie Hepzibah
- Department of Nuclear Medicine, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Antony Devasia
- Department of Urology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Santosh Kumar
- Department of Urology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Birla Roy Gnanamuthu
- Department of Thoracic Surgery, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Anuradha Chandramohan
- Department of Radiology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | | | - Nirmal Thampi John
- Department of Urology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Bijesh Yadav
- Department of Biostatistics, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Ajoy Oommen John
- Department of Medical Oncology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Josh Thomas Georgy
- Department of Medical Oncology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Subhashini John
- Department of Radiotherapy, Christian Medical College (CMC), Vellore, Tamil Nadu, India
| | - Raju Titus Chacko
- Department of Medical Oncology, Christian Medical College (CMC), Vellore, Tamil Nadu, India
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Guo Q, Liu L, Chen Z, Fan Y, Zhou Y, Yuan Z, Zhang W. Current treatments for non-small cell lung cancer. Front Oncol 2022; 12:945102. [PMID: 36033435 PMCID: PMC9403713 DOI: 10.3389/fonc.2022.945102] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/06/2022] [Indexed: 12/12/2022] Open
Abstract
Despite improved methods of diagnosis and the development of different treatments, mortality from lung cancer remains surprisingly high. Non-small cell lung cancer (NSCLC) accounts for the large majority of lung cancer cases. Therefore, it is important to review current methods of diagnosis and treatments of NSCLC in the clinic and preclinic. In this review, we describe, as a guide for clinicians, current diagnostic methods and therapies (such as chemotherapy, chemoradiotherapy, targeted therapy, antiangiogenic therapy, immunotherapy, and combination therapy) for NSCLC.
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Affiliation(s)
- Qianqian Guo
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou University, Zhengzhou, China
| | - Liwei Liu
- Department of Pharmacy, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zelong Chen
- Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Artificial Intelligence and IoT Smart Medical Engineering Research Center of Henan Province, Zhengzhou, China
| | - Yannan Fan
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou University, Zhengzhou, China
| | - Yang Zhou
- Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, China
| | - Ziqiao Yuan
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou, China
- *Correspondence: Wenzhou Zhang, ; Ziqiao Yuan,
| | - Wenzhou Zhang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou University, Zhengzhou, China
- *Correspondence: Wenzhou Zhang, ; Ziqiao Yuan,
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PET-CT in Clinical Adult Oncology-IV. Gynecologic and Genitourinary Malignancies. Cancers (Basel) 2022; 14:cancers14123000. [PMID: 35740665 PMCID: PMC9220973 DOI: 10.3390/cancers14123000] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Positron emission tomography (PET), typically combined with computed tomography (CT), has become a critical advanced imaging technique in oncology. With concurrently acquired positron emission tomography and computed tomography (PET-CT), a radioactive molecule (radiotracer) is injected in the bloodstream and localizes to sites of tumor because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan provides information to allow better visualization of radioactivity from deep or dense structures and to provide detailed anatomic information. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging and surveillance. This series of six review articles provides an overview of the value, applications, and imaging interpretive strategies for PET-CT in the more common adult malignancies. The fourth report in this series provides a review of PET-CT imaging in gynecologic and genitourinary malignancies. Abstract Concurrently acquired positron emission tomography and computed tomography (PET-CT) is an advanced imaging modality with diverse oncologic applications, including staging, therapeutic assessment, restaging and longitudinal surveillance. This series of six review articles focuses on providing practical information to providers and imaging professionals regarding the best use and interpretative strategies of PET-CT for oncologic indications in adult patients. In this fourth article of the series, the more common gynecological and adult genitourinary malignancies encountered in clinical practice are addressed, with an emphasis on Food and Drug Administration (FDA)-approved and clinically available radiopharmaceuticals. The advent of new FDA-approved radiopharmaceuticals for prostate cancer imaging has revolutionized PET-CT imaging in this important disease, and these are addressed in this report. However, [18F]F-fluoro-2-deoxy-d-glucose (FDG) remains the mainstay for PET-CT imaging of gynecologic and many other genitourinary malignancies. This information will serve as a guide for the appropriate role of PET-CT in the clinical management of gynecologic and genitourinary cancer patients for health care professionals caring for adult cancer patients. It also addresses the nuances and provides guidance in the accurate interpretation of FDG PET-CT in gynecological and genitourinary malignancies for imaging providers, including radiologists, nuclear medicine physicians and their trainees.
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PET imaging of testicular cancer. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00126-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Dondi F, Albano D, Bertagna F, Giubbini R. Tumor markers and 18F-FDG PET/CT after orchiectomy in seminoma: Is there any correlation? Rev Esp Med Nucl Imagen Mol 2021; 40:287-292. [PMID: 34425969 DOI: 10.1016/j.remnie.2020.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/23/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of our study was to analyze the potential relationship between tumor markers and 18F-fluorodoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) results in patients affected by seminoma. MATERIAL AND METHODS 65 18F-FDG PET/CT scans of 41 patients with diagnosis of seminoma were analyzed and compared to alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG). PET/CT studies were analyzed qualitatively and measuring the maximum and mean standardized uptake value body weight max (SUVbwmax, SUVbwmean), maximum SUV lean body mass (SUVlbm), maximum SUV body surface area (SUVbsa), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of hypermetabolic lesions. All values were compared with serum markers. RESULTS 31 PET/CT studies were true negative, 28 true positive, 6 false positive and 0 false negative with sensitivity of 100%, specificity of 84%, negative predictive value of 100%, positive predictive value of 82% and accuracy of 91%. No correlation between PET results and tumor marker levels was found and also between AFP and PET/CT semiquantitive parameters. All semiquantitative PET parameters were significantly related to hCG level. CONCLUSIONS 18F-FDG PET/CT has good accuracy in evaluating patients with relapsed seminoma. HCG levels were significantly correlated with metabolic PET/CT parameters.
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Affiliation(s)
- Francesco Dondi
- Nuclear Medicine, University of Brescia, Spedali Civili Brescia, Brescia, Italy.
| | - Domenico Albano
- Nuclear Medicine, University of Brescia, Spedali Civili Brescia, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, University of Brescia, Spedali Civili Brescia, Brescia, Italy
| | - Raffaele Giubbini
- Nuclear Medicine, University of Brescia, Spedali Civili Brescia, Brescia, Italy
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Abstract
Hybrid FDG PET/CT plays a vital role in oncologic imaging and has been widely adopted for the staging and restaging of a variety of malignancies. Its diagnostic value in urogenital malignancies is less well-known, not at least because of the variable FDG avidity of these tumor entities, the sites of these tumors, and technical challenges associated with sequential imaging of CT and PET. PET/CT interpretation thus can be especially challenging and is associated with many pitfalls, which can lead to both false-positive and false-negative diagnoses as well as incorrect assessment of metabolic change following therapy. Currently, FDG PET/CT is not the standard of care for the initial diagnosis or staging of early-stage or low-risk urogenital cancers; however, it can help evaluate distant metastatic disease, response to therapy, and disease recurrence in high-risk patients. Knowledge of imaging features of tumor metabolic avidity and pitfalls is essential for accurate interpretation.
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Affiliation(s)
- Anil Vasireddi
- Department of Radiology, University of Pittsburgh Medical Center, UPMC Presbyterian Hospital, Pittsburgh, PA
| | - Nghi C Nguyen
- Department of Radiology, University of Pittsburgh Medical Center, UPMC Presbyterian Hospital, Pittsburgh, PA.
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Tumor markers and 18F-FDG PET/CT after orchiectomy in seminoma:Is there any correlation? Rev Esp Med Nucl Imagen Mol 2021. [PMID: 33707138 DOI: 10.1016/j.remn.2020.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of our study was to analyze the potential relationship between tumor markers and 18F-fluorodoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) results in patients affected by seminoma. MATERIAL AND METHODS 65 18F-FDG PET/CT scans of 41 patients with diagnosis of seminoma were analyzed and compared to alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG). PET/CT studies were analyzed qualitatively and measuring the maximum and mean standardized uptake value body weight max (SUVbwmax, SUVbwmean), maximum SUV lean body mass (SUVlbm), maximum SUV body surface area (SUVbsa), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of hypermetabolic lesions. All values were compared with serum markers. RESULTS 31 PET/CT studies were true negative, 28 true positive, 6 false positive and 0 false negative with sensitivity of 100%, specificity of 84%, negative predictive value of 100%, positive predictive value of 82% and accuracy of 91%. No correlation between PET results and tumor marker levels was found and also between AFP and PET/CT semiquantitive parameters. All semiquantitative PET parameters were significantly related to hCG level. CONCLUSIONS 18F-FDG PET/CT has good accuracy in evaluating patients with relapsed seminoma. hCG levels were significantly correlated with metabolic PET/CT parameters.
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Murthy V, Karmakar S, Carlton J, Joshi A, Krishnatry R, Prabhash K, Noronha V, Bakshi G, Prakash G, Pal M, Menon S, Agrawal A, Rangarajan V. Radiotherapy for Post-Chemotherapy Residual Mass in Advanced Seminoma: A Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography-Based Risk-adapted Approach. Clin Oncol (R Coll Radiol) 2021; 33:e315-e321. [PMID: 33608206 DOI: 10.1016/j.clon.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 01/07/2021] [Accepted: 01/20/2021] [Indexed: 11/28/2022]
Abstract
AIMS There is a lack of consensus regarding the management of post-chemotherapy residual mass in classical seminoma. The use of fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) may aid the detection of residual masses harbouring viable disease and help to tailor therapy. The aim of this study was to evaluate if PET-CT could identify patients who will benefit from locoregional radiotherapy. MATERIALS AND METHODS This ethics-approved study included patients with advanced classical seminoma primarily treated with standard platinum-based first-line chemotherapy. Patients were either observed or given adjuvant radiotherapy based on the clinician's preference and followed up. For this study, patients were stratified into two groups based on FDG PET-CT residual nodal maximum standardised uptake value (SUVmax): low risk (SUVmax <3) and high risk (SUVmax ≥3). Further subgroup analysis was carried out for patients with residual nodal size ≥3 cm and SUVmax ≥3, and this was considered as the very high risk group. The diagnostic accuracy of FDG PET-CT was assessed and survival was compared between the different groups. RESULTS Sixty-nine patients were included in the study: 48 patients were observed and 21 received radiotherapy. The low and high risk groups contained 50.7% and 49.3% of the patients, respectively. The very high risk subgroup had 24 patients. At a median follow-up of 44 months, locoregional failures in the radiotherapy and observation cohorts were 0% and 30% (P = 0.059) in the very high risk subgroup and 5.8% and 29.4% (P = 0.078) in the high risk group. The positive predictive value for the very high risk and high risk groups was 30% and 17.1%, respectively. The benefit of locoregional control failed to translate into overall survival benefit. CONCLUSION A tailored, FDG PET-based risk-adapted treatment approach can refine the management of post-chemotherapy residual masses in seminoma. In this study, with the largest cohort of advanced seminoma patients treated with radiotherapy reported to date, radiotherapy seems to benefit patients with post-chemotherapy residual mass SUVmax ≥3.
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Affiliation(s)
- V Murthy
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
| | - S Karmakar
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - J Carlton
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - A Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - R Krishnatry
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - G Bakshi
- Department of Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - G Prakash
- Department of Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - M Pal
- Department of Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - S Menon
- Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, India
| | - A Agrawal
- Department of Bio-imaging, Tata Memorial Hospital, Parel, Mumbai, India
| | - V Rangarajan
- Department of Bio-imaging, Tata Memorial Hospital, Parel, Mumbai, India
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Makovník M, Rejleková K, Uhrin I, Mego M, Chovanec M. Intricacies of Radiographic Assessment in Testicular Germ Cell Tumors. Front Oncol 2021; 10:587523. [PMID: 33585206 PMCID: PMC7874236 DOI: 10.3389/fonc.2020.587523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 11/16/2020] [Indexed: 11/22/2022] Open
Abstract
Testicular germ cell tumors (GCTs) are malignancies with a unique biology, pathology, clinical appearance, and excellent outcomes. A correct radiographic assessment of GCTs is extremely important for the clinical management in several typical scenarios. Advancements in the field of diagnostic medicine bring an increasing number of sophisticated imaging methods to increase the performance of imaging studies. The conventional computed tomography (CT) remains the mainstay of diagnostic imaging in the management of GCTs. While certain improvements in the sensitivity and specificity are suggested with magnetic resonance (MR) imaging with lymphotrophic nanoparticles in evaluating retroperitoneal lymph nodes during the staging procedure, further exploration in larger prospective studies is needed. A common diagnostic dilemma is assessing the post-chemotherapy residual disease in GCTs. Several studies have consistently shown advantages in the utility of positron emission tomography (PET) scanning in post-chemotherapy residual retroperitoneal lymph nodes in patients with seminoma, but not with non-seminoma. Recommendations suggest that seminoma patients with a residual disease in the retroperitoneum larger than 3 cm should be subjected for PET scanning with 18-fluorodeoxyglucose. Relatively high sensitivity, specificity and a negative predictive value (80-95%) may guide clinical decision to spare these patients of high morbidity of an unnecessary surgery. However, a positive predictive value of around 50% renders PET scanning difficult to interpret in the case of positive finding. These patients often require extremely difficult surgical procedures with the high risk of post-operative morbidity. Therefore, seminoma patients with PET positive residual masses larger than 3 cm still remain a serious challenge in the decision making of nuclear medicine specialist, oncologists, and urologic surgeons. In this article, we aim to summarize data on controversial dilemmas in staging procedures, active surveillance, and post-chemotherapy assessment of GCTs based on the available published literature.
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Affiliation(s)
- Marek Makovník
- Radiology Department, National Cancer Institute, Bratislava, Slovakia
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Katarína Rejleková
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Ivan Uhrin
- Radiology Department, National Cancer Institute, Bratislava, Slovakia
| | - Michal Mego
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
- Translational Research Unit, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
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Murez T, Fléchon A, Savoie PH, Rocher L, Camparo P, Morel-Journel N, Ferretti L, Méjean A. [French ccAFU guidelines - update 2020-2022: testicular germ cell tumors]. Prog Urol 2020; 30:S280-S313. [PMID: 33349427 DOI: 10.1016/s1166-7087(20)30754-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE - To update French guidelines concerning testicular germ cell cancer. MATERIALS AND METHODS - Comprehensive Medline search between 2018 and 2020 upon diagnosis, treatment and follow-up of testicular germ cell cancer and treatments toxicities. Level of evidence was evaluated. RESULTS - Testicular Germ cell tumor diagnosis is based on physical examination, biology tests (serum tumor markers AFP, hCGt, LDH) and radiological assessment (scrotal ultrasound and chest, abdomen and pelvis computerized tomography). Total inguinal orchiectomy is the first-line treatment allowing characterization of the histological type, local staging and identification of risk factors for micrometastases. In case of several therapeutic options, one must inform his patient balancing risks and benefits. Surveillance is usually chosen in stage I seminoma compliant patients as the evolution rate is low between 15 to 20%. Carboplatin AUC7 is an alternative option. Radiotherapy indication should be avoided. In stage I non seminomatous patients, either surveillance or risk-adapted strategy can be applied. Staging retroperitoneal lymphadenectomy has restricted indications. Metastatic germ cell tumors are usually treated by PEB chemotherapy according to IGCCCG prognostic classification. Lombo-aortic radiotherapy is still a standard treatment for stage IIA. Residual masses should be evaluated by biological and radiological assessment 3 to 4 weeks after the end of chemotherapy. Retroperitoneal lymphadenectomy is advocated for every non seminomatous residual mass more than one cm. 18FDG uptake should be evaluated for each seminoma residual mass more than 3 cm. CONCLUSIONS - A rigorous use of classifications is mandatory to define staging since initial diagnosis. Applying treatments based on these classifications leads to excellent survival rates (99% in CSI, 85% in CSII+).
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Affiliation(s)
- T Murez
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et de transplantation rénale, CHU Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier Cedex 5, France.
| | - A Fléchon
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - P-H Savoie
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service de chirurgie urologique, hôpital d'instruction des armées Sainte-Anne, BP 600, 83800 Toulon Cedex 09, France
| | - L Rocher
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service de radiologie, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; Université Paris Saclay, BIOMAPS, 63, avenue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France
| | - P Camparo
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Institut de pathologie des Hauts-de-France, 51, rue Jeanne-d'Arc, 80000 Amiens, France
| | - N Morel-Journel
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, CHU de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - L Ferretti
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; MSP Bordeaux Bagatelle, 203, route de Toulouse, 33401 Talence, France
| | - A Méjean
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
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Abstract
PURPOSE OF REVIEW Testicular cancer is rare, but its incidence is expected to rise. [18F] fluorodeoxyglucose ([18F]FDG) PET/computed tomography (CT) added role in testicular cancer management has been defined in a set of specific clinical settings. The current review focuses on recent advances in the employment of PET/CT in testicular cancer patients. RECENT FINDINGS [18F]FDG PET/CT is not recommended for initial staging or for suspected testicular tumours. PET/CT role in testicular cancer management is mainly for the assessment of seminoma residual masses after therapy (>3 cm). Although [18F]FDG PET/CT has a very high negative predictive value, its positive predictive value varies across studies: appropriate PET/CT scheduling after therapy and a careful history are mandatory for accurate interpretation. Interim PET/CT could prove valuable to spare subsequent chemotherapy cycles in patients already in remission, reducing related toxicity. The role of [18F]FDG in nonseminoma tumours is hampered by the low sensitivity in teratoma. SUMMARY [18F]FDG PET/CT is currently used for the assessment of seminoma residual masses (>3 cm) after therapy. A negative PET could also spare unnecessary further chemotherapy cycles in responding patients, reducing toxicity. Although rare, testicular secondary lesions can be detected with non[18F]FDG tracers when PET/CT is performed for other primary tumours.
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Abstract
Retroperitoneal lymph node dissection (RPLND) is an infrequently used, but important part of the management of men with metastatic germ cell tumours. The surgery aims to remove the lymph nodes from the primary retroperitoneal landing site from testicular tumours, usually accomplished by removing tissue surrounding the great vessels using a split-and-roll technique. RPLND may be carried out as a primary surgical procedure for staging or treatment of metastases. More frequently it is undertaken as a follow-up after chemotherapy for a residual mass that may contain viable tumour or teratoma. RPLND is recognised as a major surgery with significant risks of morbidity and complications, particularly loss of ejaculation secondary to damage to hypogastric nerves. In select cases, especially during primary RPLND, nerve-sparing surgery may help preserve ejaculation, which maybe of importance to the young men usually treated for germ cell tumours. In recent years, the development of minimally invasive approaches have also offered a means for potential improvement in the pain and post-operative recovery from RPLND. We conducted a narrative review of the literature to assess indications for RPLND, along with operative approaches and techniques and related outcomes. The majority of available literature is in the form of relatively small retrospective case series, hence additional research in this area is desirable.
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Affiliation(s)
- Vy Tran
- Department of Urology, Eastern Health, Box Hill, Victoria, Australia
| | - Luke Gibson
- Department of Urology, Eastern Health, Box Hill, Victoria, Australia
| | - Shomik Sengupta
- Department of Urology, Eastern Health, Box Hill, Victoria, Australia.,Eastern health Clinical School, Monash University, Box Hill, Victoria, Australia.,Department of Surgery, University of Melbourne, Heidelberg, Victoria, Australia
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Farolfi A, Koschel S, Murphy DG, Fanti S. PET imaging in urology: a rapidly growing successful collaboration. Curr Opin Urol 2020; 30:623-627. [PMID: 32701721 DOI: 10.1097/mou.0000000000000800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To discuss and highlight the recent findings in urological oncology focusing on nuclear medicine advances on imaging and therapy. RECENT FINDINGS Testicular tumors: F-FDG as the standard positron emission tomography (PET) tracer with proven good accuracy in detecting metastatic testicular cancer; urothelial cancer: good accuracy of F-FDG PET in detecting distant metastases but poor results in detecting local disease; prostate cancer: prostate-specific membrane antigen (PSMA) is a promising target for imaging prostate cancer with unprecedented accuracy in both staging and restaging and prospective studies were recently published. In castration-resistant prostate cancer, PSMA-targeting radionuclide therapy is showing potential as a curative possibility (e.g. using Lu-PSMA); renal cell cancer (RCC): besides FDG other PET radiotracers are under clinical evaluation (e.g. antibody-based molecular imaging, metabolic radiotracers and PSMA-based tracers). PSMA-based imaging may have applications in staging clear-cell RCC and in the selection and in the antiangiogenic treatment's response assessment. Possible role of PSMA-targeting radionuclide therapy? SUMMARY In urological oncology, the use of F-FDG has been limited by a generally low tumor uptake and physiological F-FDG excretion by the urinary system. Other radiotracers are increasing the urologist's portfolio allowing imaging of several biochemical pathways. Theragnostic possibilities are also under investigation thanks to PSMA-based tracers.
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Affiliation(s)
- Andrea Farolfi
- Nuclear Medicine Unit, University of Bologna, S. Orsola Hospital, Italy
| | - Samantha Koschel
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia
| | - Stefano Fanti
- Nuclear Medicine Unit, University of Bologna, S. Orsola Hospital, Italy
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O'Shea A, Kilcoyne A, Hedgire SS, Harisinghani MG. Pelvic lymph nodes and pathways of disease spread in male pelvic malignancies. Abdom Radiol (NY) 2020; 45:2198-2212. [PMID: 31673716 DOI: 10.1007/s00261-019-02285-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Accurate nodal staging for male urogenital malignancies has important implications for therapy and prognosis. Male pelvic malignancies, including prostatic, penile, testicular, and bladder cancer, typically metastasize to regional lymph nodes first which is reported by the N-stage. Spread beyond these groups to non-regional nodes is regarded as M-stage disease. METHODS In this review, we discuss the typical patterns of male pelvic lymphatic drainage and the tumor-specific regional nodal chains. RESULTS The impact of tumor-specific imaging features and the implications of previous treatments on staging are discussed. CONCLUSIONS While anatomic imaging, including CT and MRI, is the most widely employed imaging modality at present, newer functional imaging techniques have demonstrated promise in the accurate identification and characterization of nodal metastases.
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Affiliation(s)
- Aileen O'Shea
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
| | - Aoife Kilcoyne
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Sandeep S Hedgire
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Mukesh G Harisinghani
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses. CONTRAST MEDIA & MOLECULAR IMAGING 2020; 2020:5282698. [PMID: 32405280 PMCID: PMC7196984 DOI: 10.1155/2020/5282698] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 02/07/2023]
Abstract
Purpose Several meta-analyses have reported data about the diagnostic performance of positron emission tomography or positron emission tomography/computed tomography (PET or PET/CT) with different radiotracers in patients with suspicious lung cancer (LC) or pleural tumours (PT). This review article aims at providing an overview on the recent evidence-based data in this setting. Methods A comprehensive literature search of meta-analyses published in PubMed/MEDLINE and Cochrane Library database from January 2010 through March 2020 about the diagnostic performance of PET or PET/CT with different radiotracers in patients with suspicious LC or PT was performed. This combination of keywords was used: (A) “PET” OR “positron emission tomography” AND (B) “lung” OR “pulmonary” OR “pleur∗” AND (C) meta-analysis. Only meta-analyses on PET or PET/CT in patients with suspicious LC or PT were selected. Results We have summarized the diagnostic performance of PET or PET/CT with fluorine-18 fluorodeoxyglucose (18F-FDG) and other radiotracers taking into account 17 meta-analyses. Evidence-based data demonstrated a good diagnostic performance of 18F-FDG PET or PET/CT for the characterization of solitary pulmonary nodules (SPNs) or pleural lesions with overall higher sensitivity than specificity. Evidence-based data do not support the routine use of dual time point (DTP) 18F-FDG PET/CT or fluorine-18 fluorothymidine (18F-FLT) PET/CT in the differential diagnosis of SPNs. Even if 18F-FDG PET/CT has high sensitivity and specificity as a selective screening modality for LC, its role in this setting remains unknown. Conclusions Evidence-based data about the diagnostic performance of PET/CT with different radiotracers for suspicious LC or PT are increasing, with good diagnostic performance of 18F-FDG PET/CT. More prospective multicenter studies and cost-effectiveness analyses are warranted.
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Ali JS, Ain NU, Naz S, Zia M. Biomarker selection and imaging design in cancer: A link with biochemical pathways for imminent engineering. Heliyon 2020; 6:e03340. [PMID: 32055737 PMCID: PMC7005466 DOI: 10.1016/j.heliyon.2020.e03340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 05/27/2019] [Accepted: 01/29/2020] [Indexed: 01/15/2023] Open
Abstract
Malignant cells reprogram metabolic pathways to meet the demands of growth and proliferation. These altered manners of metabolism are now identified as hallmarks of cancer. Studies have revealed tumor cells alter specific pathways such as glycolysis, fatty acid synthesis and amino acid synthesis to support their proliferation. In this review, we provide a theoretical framework to understand metabolic reprogramming and the mechanisms accompanying distorted metabolism to tumor progression. How these alterations will be assisting in cancer diagnostics and advances in standard techniques in marker identification and imagining are also discussed.
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Affiliation(s)
| | | | | | - Muhammad Zia
- Department of Biotechnology, Quaid-i-Azam University Islamabad 45320 Pakistan
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Abstract
Molecular imaging with positron emission tomography (PET) using tumour-seeking radiopharmaceuticals has gained wide acceptance in oncology with many clinical applications. The hybrid imaging modality PET/CT (computed tomography) allows assessing molecular as well as morphologic information at the same time. Therefore, PET/CT represents an efficient tool for whole-body staging and re-staging within one imaging modality. In oncology, the glucose analogue 18-F-fluorodeoxyglucose (FDG) is the most widely used PET/CT radiopharmaceutical in clinical routine. FDG PET and FDG PET/CT have been used for staging and re-staging of tumour patients in numerous studies. This chapter will discuss the use and the main indications of FDG PET/CT in oncology with special emphasis on lung cancer, lymphoma, head and neck cancer, melanoma and breast cancer (among other tumour entities). A review of the current literature is given with respect to primary diagnosis, staging and diagnosis of recurrent disease. Besides its integral role in diagnosis, staging and re-staging of disease in oncology, there is increasing evidence that FDG PET/CT can be used for therapy response assessment (possibly influencing therapeutic management and treatment planning) by evaluating tumour control, which will also be discussed in this chapter.
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Affiliation(s)
- Juliane Becker
- Department of Nuclear Medicine, University Medicine Rostock, Gertrudenplatz 1, 18057, Rostock, Germany
| | - Sarah M Schwarzenböck
- Department of Nuclear Medicine, University Medicine Rostock, Gertrudenplatz 1, 18057, Rostock, Germany
| | - Bernd J Krause
- Department of Nuclear Medicine, University Medicine Rostock, Gertrudenplatz 1, 18057, Rostock, Germany.
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Ghodoussipour S, Daneshmand S. Surgical strategies for postchemotherapy testis cancer. Transl Androl Urol 2020; 9:S74-S82. [PMID: 32055488 PMCID: PMC6995844 DOI: 10.21037/tau.2019.09.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 09/20/2019] [Indexed: 11/06/2022] Open
Abstract
The surgical management of disseminated disease has long been an essential component in the management of patients with testis cancer. While the indications for surgery have been narrowed since the advent of cisplatin based chemotherapy, resection remains essential to provide long-term survival. The indications for surgery vary by histology and rely on adequate preoperative imaging to evaluate for residual disease. Surgery for postchemotherapy testis cancer is challenging and requires that surgeons be prepared for extraretroperitoneal resections and adjunctive procedures as necessary. Herein, we review the imaging options that are essential for surgical planning and the various surgical techniques that are often necessary in this challenging situation.
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Affiliation(s)
- Saum Ghodoussipour
- USC/Norris Comprehensive Cancer Center, Institute of Urology, Los Angeles, CA 90089, USA
| | - Siamak Daneshmand
- USC/Norris Comprehensive Cancer Center, Institute of Urology, Los Angeles, CA 90089, USA
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PET/CT in Renal, Bladder, and Testicular Cancer. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Honecker F, Aparicio J, Berney D, Beyer J, Bokemeyer C, Cathomas R, Clarke N, Cohn-Cedermark G, Daugaard G, Dieckmann KP, Fizazi K, Fosså S, Germa-Lluch JR, Giannatempo P, Gietema JA, Gillessen S, Haugnes HS, Heidenreich A, Hemminki K, Huddart R, Jewett MAS, Joly F, Lauritsen J, Lorch A, Necchi A, Nicolai N, Oing C, Oldenburg J, Ondruš D, Papachristofilou A, Powles T, Sohaib A, Ståhl O, Tandstad T, Toner G, Horwich A. ESMO Consensus Conference on testicular germ cell cancer: diagnosis, treatment and follow-up. Ann Oncol 2019; 29:1658-1686. [PMID: 30113631 DOI: 10.1093/annonc/mdy217] [Citation(s) in RCA: 195] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The European Society for Medical Oncology (ESMO) consensus conference on testicular cancer was held on 3-5 November 2016 in Paris, France. The conference included a multidisciplinary panel of 36 leading experts in the diagnosis and treatment of testicular cancer (34 panel members attended the conference; an additional two panel members [CB and K-PD] participated in all preparatory work and subsequent manuscript development). The aim of the conference was to develop detailed recommendations on topics relating to testicular cancer that are not covered in detail in the current ESMO Clinical Practice Guidelines (CPGs) and where the available level of evidence is insufficient. The main topics identified for discussion related to: (1) diagnostic work-up and patient assessment; (2) stage I disease; (3) stage II-III disease; (4) post-chemotherapy surgery, salvage chemotherapy, salvage and desperation surgery and special topics; and (5) survivorship and follow-up schemes. The experts addressed questions relating to one of the five topics within five working groups. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel. A consensus vote was obtained following whole-panel discussions, and the consensus recommendations were then further developed in post-meeting discussions in written form. This manuscript presents the results of the expert panel discussions, including the consensus recommendations and a summary of evidence supporting each recommendation. All participants approved the final manuscript.
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Affiliation(s)
- F Honecker
- Tumor and Breast Center ZeTuP, St. Gallen, Switzerland; Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center, Hamburg, Germany.
| | - J Aparicio
- Department of Medical Oncology, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - D Berney
- Department of Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - J Beyer
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center, Hamburg, Germany
| | - R Cathomas
- Department of Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland
| | - N Clarke
- Department of Surgery, The Christie NHS Foundation Trust, Manchester, UK
| | - G Cohn-Cedermark
- Department of Oncology-Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - G Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K-P Dieckmann
- Department of Urology, Asklepios Klinik Altona, Hamburg, Germany
| | - K Fizazi
- Department of Cancer Medicine, Gustave Roussy, University of Paris Sud, Villejuif, France
| | - S Fosså
- Department of Oncology, Oslo University Hospital Radiumhospitalet, Oslo, Norway
| | - J R Germa-Lluch
- Department of Medical Oncology, Catalan Institute of Oncology (ICO), Barcelona University, Barcelona, Spain
| | - P Giannatempo
- Department of Medical Oncology, Fondazione IRCCS Istituto dei Tumori, Milan, Italy
| | - J A Gietema
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - S Gillessen
- Department of Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen; University of Bern, Bern, Switzerland
| | - H S Haugnes
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway; Institute of Clinical Medicine, UIT - The Arctic University, Tromsø, Norway
| | - A Heidenreich
- Department of Urology, Uro-Oncology, Robot-assisted and Specialised Urologic Surgery, University of Cologne, Cologne, Germany
| | - K Hemminki
- Department of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - R Huddart
- Department of Radiotherapy and Imaging, The Institute of Cancer Research, Royal Marsden Hospital, Sutton, UK
| | - M A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Canada
| | - F Joly
- Department of Urology-Gynaecology, Centre Francois Baclesse, Caen, France
| | - J Lauritsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A Lorch
- Department of Urology, Genitourinary Medical Oncology, Heinrich-Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - A Necchi
- Department of Medical Oncology, Fondazione IRCCS Istituto dei Tumori, Milan, Italy
| | - N Nicolai
- Department of Surgery, Urology and Testis Surgery Unit, Fondazione IRCCS Istituto dei Tumori, Milan, Italy
| | - C Oing
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center, Hamburg, Germany
| | - J Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - D Ondruš
- 1st Department of Oncology, St. Elisabeth Cancer Institute, Comenius University Faculty of Medicine, Bratislava, Slovak Republic
| | - A Papachristofilou
- Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | - T Powles
- Department of Medical Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - A Sohaib
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
| | - O Ståhl
- Department of Oncology, Skane University Hospital, Lund University, Lund, Sweden
| | - T Tandstad
- The Cancer Clinic, St. Olavs Hospital, Trondheim, Norway
| | - G Toner
- Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia
| | - A Horwich
- The Institute of Cancer Research, Royal Marsden Hospital, Sutton, UK
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Murez T, Fléchon A, Savoie PH, Rocher L, Camparo P, Morel-Journel N, Ferretti L, Sèbe P, Méjean A. [French ccAFU guidelines - Update 2018-2020: Testicular germ cell tumors]. Prog Urol 2019; 28 Suppl 1:R149-R166. [PMID: 31610870 DOI: 10.1016/j.purol.2019.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To update French guidelines concerning testicular germ cell cancer. METHODS Comprehensive Medline search between 2016 and 2018 upon diagnosis, treatment and follow-up of testicular germ cell cancer and treatments toxicities. Level of evidence was evaluated. RESULTS Testicular Germ cell tumor diagnosis is based on physical examination, biology tests (serum tumor markers AFP, hCGt, LDH) and radiological assessment (scrotal ultrasound and chest, abdomen and pelvis computerized tomography). Total inguinal orchiectomy is the first- line treatment allowing characterization of the histological type, local staging and identification of risk factors for micrometastases. In case of several therapeutic options, one must inform his patient balancing risks and benefits. Surveillance is usually chosen in stage I seminoma compliant patients as the evolution rate is low between 15 to 20 %. Carboplatin AUC7 is an alternative option. Radiotherapy indication should be avoided. In stage I non-seminomatous patients, either surveillance or risk-adapted strategy can be applied. Staging retroperitoneal lymphadenectomy has restricted indications. Metastatic germ cell tumors are usually treated by PEB chemotherapy according to IGCCCG prognostic classification. Lombo-aortic radiotherapy is still a standard treatment for stage IIA. Residual masses should be evaluated by biological and radiological assessment 3 to 4 weeks after the end of chemotherapy. Retroperitoneal lymphadenectomy is advocated for every non-seminomatous residual mass more than one cm. 18FDG uptake should be evaluated for each seminoma residual mass more than 3cm. CONCLUSIONS A rigorous use of classifications is mandatory to define staging since initial diagnosis. Applying treatments based on these classifications leads to excellent survival rates (99 % in CSI, 85 % in CSII+).
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Affiliation(s)
- T Murez
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, CHRU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
| | - A Fléchon
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'oncologie médicale, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - P-H Savoie
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital d'instruction des armées Sainte-Anne, BP 600, 83800 Toulon cedex 09, France
| | - L Rocher
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service de radiologie, CHU Paris Sud, site Kremlin-Bicêtre, AP-HP, 94270 Le Kremlin-Bicêtre, France
| | - P Camparo
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Centre de pathologie, 51, rue de Jeanne-D'Arc, 80000 Amiens, France
| | - N Morel-Journel
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, centre hospitalier Lyon Sud (Pierre Bénite), HCL groupement hospitalier du Sud, 69495 Pierre Bénite cedex, France
| | - L Ferretti
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, MSP de Bordeaux-Bagatelle, 203, route de Toulouse, BP 50048, 33401 Talence cedex, France
| | - P Sèbe
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - A Méjean
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital européen Georges-Pompidou, université Paris Descartes, AP-HP, 75015 Paris, France
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The role of 18F-FDG-PET/CT in evaluating retroperitoneal masses -Keeping your eye on the ball! Cancer Imaging 2019; 19:28. [PMID: 31142361 PMCID: PMC6542013 DOI: 10.1186/s40644-019-0217-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022] Open
Abstract
Background Testicular germ cell tumour is the commonest malignancy affecting males aged between 15 and 35, with an increased relative risk amongst those with a history of cryptorchidism. In patients presenting with locoregional metastatic disease, retroperitoneal and pelvic soft tissue masses are common findings on ultrasound and computed tomography, which has several differential diagnoses within this demographic cohort. On staging 18F-FDG-PET/CT, understanding the typical testicular lymphatic drainage pathway facilitates prompt recognition of the pathognomonic constellation of unilateral absence of testicular scrotal activity, and FDG-avid nodal masses along the drainage pathway. We describe the cases of three young males presenting with abdominopelvic masses, in whom FDG-PET/CT was helpful in formulating a unifying diagnosis of metastatic seminoma, retrospectively corroborated by a history of testicular maldescent. Case presentations In all three cases, the patients were males aged in their 30s and 40s who were brought to medical attention for back and lower abdominal pain of varying duration. Initial imaging evaluation with computed tomography and/or ultrasound revealed large abdominopelvic soft tissue masses, with lymphoproliferative disorders or soft tissue sarcomas being high on the list of differential diagnoses. As such, they were referred for staging FDG-PET/CT, all of whom demonstrated the pathognomonic constellation of, 1) unilateral absence of scrotal testicular activity, and 2) FDG-avid nodal masses along the typical testicular lymphatic drainage pathway. These characteristic patterns were corroborated by a targeted clinical history and examination which revealed a history of cryptorchidism, and elevated β-hCG in two of three patients. All were subsequently confirmed as metastatic seminoma on biopsy and open resection. Conclusion These cases highlight the importance of clinical history and examination for the clinician, as well as a sound knowledge of the typical testicular lymphatic drainage pathway for the PET physician, which would assist with prompt recognition of the characteristic imaging patterns on FDG-PET/CT. It further anecdotally supports the utility of FDG-PET/CT in evaluating undiagnosed abdominopelvic masses, as well as a potential role in the initial staging of germ cell tumours in appropriately selected patients.
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Joice GA, Rowe SP, Gorin MA, Pierorazio PM. Molecular Imaging for Evaluation of Viable Testicular Cancer Nodal Metastases. Curr Urol Rep 2018; 19:110. [DOI: 10.1007/s11934-018-0863-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Murez T, Fléchon A, Savoie PH, Rocher L, Camparo P, Morel-Journel N, Ferretti L, Sèbe P, Méjean A. RETRACTED: Recommandations françaises du Comité de Cancérologie de l’AFU — Actualisation 2018—2020 : tumeurs germinales du testicule French ccAFU guidelines — Update 2018—2020: Testicular germ cell tumors. Prog Urol 2018; 28:S147-S164. [PMID: 30472999 DOI: 10.1016/j.purol.2018.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 11/30/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy).
Cet article est retiré de la publication à la demande des auteurs car ils ont apporté des modifications significatives sur des points scientifiques après la publication de la première version des recommandations.
Le nouvel article est disponible à cette adresse: doi:10.1016/j.purol.2019.01.009.
C’est cette nouvelle version qui doit être utilisée pour citer l’article.
This article has been retracted at the request of the authors, as it is not based on the definitive version of the text because some scientific data has been corrected since the first issue was published.
The replacement has been published at the doi:10.1016/j.purol.2019.01.009.
That newer version of the text should be used when citing the article.
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Affiliation(s)
- T Murez
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, CHRU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
| | - A Fléchon
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'oncologie médicale, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - P-H Savoie
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital d'instruction des armées Sainte-Anne, BP 600, 83800 Toulon cedex 09, France
| | - L Rocher
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service de radiologie, CHU Paris Sud, site Kremlin-Bicêtre, AP-HP, 94270 Le Kremlin-Bicêtre, France
| | - P Camparo
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Centre de pathologie, 51, rue de Jeanne-D'Arc, 80000 Amiens, France
| | - N Morel-Journel
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, centre hospitalier Lyon Sud (Pierre Bénite), HCL groupement hospitalier du Sud, 69495 Pierre Bénite cedex, France
| | - L Ferretti
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, MSP de Bordeaux-Bagatelle, 203, route de Toulouse, BP 50048, 33401 Talence cedex, France
| | - P Sèbe
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France
| | - A Méjean
- Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital européen Georges-Pompidou, université Paris Descartes, AP-HP, 75015 Paris, France
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Cathomas R, Klingbiel D, Bernard B, Lorch A, Garcia Del Muro X, Morelli F, De Giorgi U, Fedyanin M, Oing C, Haugnes HS, Hentrich M, Fankhauser C, Gillessen S, Beyer J. Questioning the Value of Fluorodeoxyglucose Positron Emission Tomography for Residual Lesions After Chemotherapy for Metastatic Seminoma: Results of an International Global Germ Cell Cancer Group Registry. J Clin Oncol 2018; 36:JCO1800210. [PMID: 30285559 DOI: 10.1200/jco.18.00210] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Residual lesions after chemotherapy are frequent in metastatic seminoma. Watchful waiting is recommended for lesions < 3 cm as well as for fluorodeoxyglucose (FDG) positron emission tomography (PET)-negative lesions ≥ 3 cm. Information on the optimal management of PET-positive residual lesions ≥ 3 cm is lacking. PATIENTS AND METHODS We retrospectively identified 90 patients with metastatic seminoma with PET-positive residual lesions after chemotherapy. Patients with elevated α-fetoprotein or nonseminomatous histology were excluded. We analyzed the post-PET management and its impact on relapse and survival and calculated the positive predictive value (PPV) for PET. RESULTS Median follow-up time was 29 months (interquartile range [IQR], 10 to 62 months). Median diameter of the largest residual mass was 4.9 cm (range, 1.1 to 14 cm), with masses located in the retroperitoneum (77%), pelvis (16%), mediastinum (17%), and/or lung (3%). Median time from the last day of chemotherapy to PET was 6.9 weeks (IQR, 4.4 to 9.9 weeks). Post-PET management included repeated imaging in 51 patients (57%), resection in 26 patients (29%), biopsy in nine patients (10%) and radiotherapy in four patients (4%). Histology of the resected specimen was necrosis in 21 patients (81%) and vital seminoma in five patients (19%). No biopsy revealed vital seminoma. Relapse or progression occurred in 15 patients (17%) after a median of 3.7 months (IQR, 2.5 to 4.9 months) and was found in 11 (22%) of 51 patients on repeated imaging, in two (8%) of 26 patients after resection, and in two (22%) of nine patients after biopsy. All but one patient who experienced relapse were successfully treated with salvage therapy. The PPV for FDG-PET was 23%. CONCLUSION FDG-PET has a low PPV for vital tumor in residual lesions after chemotherapy in patients with metastatic seminoma. This cautions against clinical decisions based on PET positivity alone.
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Affiliation(s)
- Richard Cathomas
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Dirk Klingbiel
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Brandon Bernard
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Anja Lorch
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Xavier Garcia Del Muro
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Franco Morelli
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Ugo De Giorgi
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Mikhail Fedyanin
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Christoph Oing
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Hege Sagstuen Haugnes
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Marcus Hentrich
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Christian Fankhauser
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Silke Gillessen
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
| | - Jörg Beyer
- Richard Cathomas, Kantonsspital Graubünden, Chur; Dirk Klingbiel, Swiss Group for Clinical Cancer Research Coordinating Center; Silke Gillessen, University of Bern; Jörg Beyer, Inselspital, Bern University Hospital, University of Bern, Bern; Christian Fankhauser, University of Zürich, Zürich; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Brandon Bernard, Dana-Farber Cancer Institute, Boston, MA; Anja Lorch, University of Düsseldorf, Düsseldorf; Christoph Oing, University Medical Center Hamburg-Eppendorf, Hamburg; Marcus Hentrich, Rotkreuzklinikum München, München, Germany; Xavier Garcia del Muro, Institute Catalan of Oncology, Bellvitge Biomedical Research Institute, University of Barcelona, Barcelona, Spain; Franco Morelli, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo; Ugo De Giorgi, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto di Ricovero e Cura a Carattere Scientifico, Meldola, Italy; Mikhail Fedyanin, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia; and Hege Sagstuen Haugnes, University Hospital of North Norway and Universitetet i Tromsø-The Arctic University, Tromsø, Norway
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Abstract
Testicular germ cell tumors are one of the most common neoplasms in young men. After inguinal orchiectomy is performed, treatment options range from active surveillance to chemotherapy, radiation therapy or retroperitoneal lymphadenectomy. For the accurate use of the different treatment options, precise imaging techniques are necessary to reduce side effects of the aggressive therapies but also to avoid undertreatment exposing the patient to the risk of recurrence. F-FDG PET/CT is already recommended in the European guidelines for the follow up of seminomas under certain conditions but conventional primary staging or restaging is still performed with CT or MRI. Recently, the importance of F-FDG PET/CT in this context has become an interesting topic of academic discussion and subject of various clinical trials which are reviewed in the following.
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Affiliation(s)
- Robert Dotzauer
- Department of Urology, University Hospital Mainz, Mainz, Germany
| | - Christian Thomas
- Department of Urology, University Hospital Mainz, Mainz, Germany
| | - Wolfgang Jäger
- Department of Urology, University Hospital Mainz, Mainz, Germany
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Rauscher I, Eiber M, Weber WA, Gschwend JE, Horn T, Maurer T. Positron-emission tomography imaging in urological oncology: Current aspects and developments. Int J Urol 2018; 25:912-921. [DOI: 10.1111/iju.13779] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/17/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Isabel Rauscher
- Department of Nuclear Medicine; Klinikum rechts der Isar; Technical University of Munich; Munich Germany
| | - Matthias Eiber
- Department of Nuclear Medicine; Klinikum rechts der Isar; Technical University of Munich; Munich Germany
| | - Wolfgang A Weber
- Department of Nuclear Medicine; Klinikum rechts der Isar; Technical University of Munich; Munich Germany
| | - Jürgen E Gschwend
- Department of Urology; Klinikum rechts der Isar; Technical University of Munich; Munich Germany
| | - Thomas Horn
- Department of Urology; Klinikum rechts der Isar; Technical University of Munich; Munich Germany
| | - Tobias Maurer
- Department of Urology; Klinikum rechts der Isar; Technical University of Munich; Munich Germany
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Albano D, Caobelli F, Quartuccio N, Fiasconaro E, Messina M, Spada M, Alongi P. PET/CT for the diagnostic assessment of patients with testicular cancer. Clin Transl Imaging 2018. [DOI: 10.1007/s40336-018-0277-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Robot-assisted post-chemotherapy retroperitoneal lymph node dissection in germ cell tumor: is the single-docking with lateral approach relevant? World J Urol 2018; 36:655-661. [PMID: 29353314 DOI: 10.1007/s00345-018-2177-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/03/2018] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Surgical treatment of post-chemotherapy residual mass of germ cell tumor (GCT) may be performed in various techniques. We assess the feasibility, safety, and efficacy of single-docking with lateral approach robot-assisted retroperitoneal lymph node dissection (R-RPLND) in residual mass of GCT in our center. MATERIALS AND METHODS A retrospective review of patients undergoing R-RPLND for residual mass of CGT was performed between January 2014 and April 2017. Patients with residual mass < 3 cm for seminoma or < 1 cm for non-seminoma were eligible. All surgeries were performed with single-docking RPNLD technique in lateral decubitus. We assessed preoperative characteristics (age, testicular pathology, template, chemotherapy regimen, lesion size, and clinical stage), peroperative (operative time, estimated blood loss, intraoperative complication, node count, pathology, and number of positive node), and postoperative outcomes (postoperative complications, hospital length of stay, recurrence-free survival at 2 year, and ejaculation dysfunction). RESULTS Eleven patients underwent R-RPLND with a median size of the residual mass of 20 mm. Median operative time was 153 min with 120 ml of estimated blood loss, without intraoperative complication. Median nodes count was 7 [1; 24]. Two patients had post-chemotherapy necrotic nodes and one no tumorous node. One patient had postoperative Clavien I complication (chyloperitoneum). We report 72.7% of antegrade ejaculation at 1 month from the surgery. Median clinical recurrence-free survival was 100% after 2 years from the surgery (n = 6). CONCLUSION Lateral approach with single-docking R-RPLND for residual mass of GCT is feasible and safe, with satisfying functional and oncologic outcomes.
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Razik A, Das CJ, Sharma S. PET-CT and PET-MR in urological cancers other than prostate cancer: An update on state of the art. Indian J Urol 2018; 34:20-27. [PMID: 29343908 PMCID: PMC5769244 DOI: 10.4103/iju.iju_321_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Hybrid positron emission tomography with computed tomography (PET/CT) and magnetic resonance imaging (PET/MRI) have enabled the combination of morphologic and functional imaging with the promise of providing better information in guiding therapy. Further advance has been made in the past decade with the development of newer radiotracers and optimization of the technical aspects. We performed a search in PubMed, Scopus, and Google Scholar for peer-reviewed literature concerning the advances and newer developments in the imaging of nonprostate urologic cancers between 2005 and 2017. This review aims at summarizing the current evidence on PET imaging in nonprostate urologic cancers and their impact on the diagnosis, staging, prognostication, response assessment, and restaging of these malignancies. However, much of the evidence is still in infancy and has not been incorporated into routine management or the practice guidelines of National Comprehensive Cancer Network or European Society for Medical Oncology (ESMO).
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Affiliation(s)
- Abdul Razik
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chandan Jyoti Das
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Sharma
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
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40
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Alongi P, Evangelista L, Caobelli F, Spallino M, Gianolli L, Midiri M, Picchio M. Diagnostic and prognostic value of 18F-FDG PET/CT in recurrent germinal tumor carcinoma. Eur J Nucl Med Mol Imaging 2017; 45:85-94. [DOI: 10.1007/s00259-017-3811-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/11/2017] [Indexed: 11/30/2022]
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Oldan JD, Shah SN, Rose TL. Applications of PET/MR Imaging in Urogynecologic and Genitourinary Cancers. Magn Reson Imaging Clin N Am 2017; 25:335-350. [PMID: 28390533 DOI: 10.1016/j.mric.2016.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Positron emission tomograph (PET)-magnetic resonance (MR) is a new modality combining PET and MR. In gynecologic cancers it can be used for staging of cervical and endometrial cancer, planning of radiation therapy in cervical cancer, assessing response to chemotherapy in ovarian cancer, and detection of recurrence in most gynecologic cancers. It is being explored for prostate cancer and other genitourinary cancers, but is still in experimental stages.
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Affiliation(s)
- Jorge D Oldan
- Nuclear Medicine, Department of Radiology, University of North Carolina School of Medicine, Chairman's Office, 2006 Old Clinic, CB# 7510, Chapel Hill, NC 27599, USA.
| | - Shetal N Shah
- Abdominal Imaging Section and Nuclear Medicine Department, Imaging Institute and Taussig Cancer Institute, Cleveland Clinic Main Campus, Mail Code JB3, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Tracy Lynn Rose
- Hematology-Oncology, N.C. Cancer Hospital, 101 Manning Drive, Second Floor, Chapel Hill, NC 27514, USA
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Durand X, Fléchon A, Murez T, Rocher L, Camparo P, Morel-Journel N, Savoie PH, Ferretti L, Sèbe P, Méjean A. Recommandations en onco-urologie 2016-2018 du CCAFU : Tumeurs germinales testiculaires. Prog Urol 2016; 27 Suppl 1:S147-S165. [DOI: 10.1016/s1166-7087(16)30706-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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43
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ACR Appropriateness Criteria Staging of Testicular Malignancy. J Am Coll Radiol 2016; 13:1203-1209. [DOI: 10.1016/j.jacr.2016.06.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 06/13/2016] [Accepted: 06/15/2016] [Indexed: 01/06/2023]
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Update on advances in molecular PET in urological oncology. Jpn J Radiol 2016; 34:470-85. [PMID: 27222021 DOI: 10.1007/s11604-016-0553-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/07/2016] [Indexed: 12/28/2022]
Abstract
Integrated positron emission tomography/computed tomography (PET/CT) with 2-[(18)F]fluoro-2-deoxy-D-glucose ((18)F-FDG) has emerged as a powerful tool for the combined metabolic and anatomic evaluation of many cancers. In urological oncology, however, the use of (18)F-FDG has been limited by a generally low tumor uptake, and physiological excretion of FDG through the urinary system. (18)F-FDG PET/CT is useful when applied to specific indications in selected patients with urological malignancy. New radiotracers and positron emission tomography/magnetic resonance imaging (PET/MRI) are expected to further improve the performance of PET in uro-oncology.
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46
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Abstract
Imaging plays an important role in the clinical management of cancer patients. Hybrid imaging with PET/computed tomography (CT) is having a broad impact in oncology, and in recent years PET/CT is beginning to have an impact in urooncology. In both bladder and renal cancers, there is a need to study the efficacy of other tracers than F-18 fluorodeoxyglucose (FDG), particularly tracers with limited renal excretion. Thus, new tracers are being introduced. This review focuses on the clinical role of FDG and other PET agents in renal, bladder, and testicular cancers.
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