key papersKey paper
SEMPET: FDG-PET as a predictor of viable tumour in post-chemotherapy seminoma residuals
A PET scan reliably told apart residual masses that still contained living seminoma from scar tissue after chemotherapy, allowing surgeons to leave PET-negative masses alone rather than operating on all masses over 3 cm.
Overview
Prospective multicentre study of 51 patients with metastatic seminoma and residual masses after chemotherapy who underwent FDG-PET, with results validated against histology or clinical follow-up.
PET had a sensitivity of 80 percent and specificity of 100 percent for viable tumour, and for residual lesions over 3 cm specificity and sensitivity were both 100 percent, outperforming CT size criteria.
Observational studyChanged practice51 participants232 citations
Authors
De Santis M, Becherer A, Bokemeyer C, et al.
Published
Findings
- Specificity 100 percent, sensitivity 80 percent for viable residual seminoma.
- Sensitivity and specificity 100 percent for lesions over 3 cm.
What it means
FDG-PET is standard for residual seminoma masses larger than 3 cm after chemotherapy, sparing most men surgery.
Caveats
- Small study; false positives occur when PET is done too soon after chemotherapy, so scans are delayed at least six weeks.