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The impact of systemic chemotherapy on testicular FDG activity in young men with Hodgkin’s lymphoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Based on prior reports suggesting a positive correlation between fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/CT and total sperm count and concentration, we sought to identify changes in testicular FDG uptake over the course of chemotherapy in young men with Hodgkin’s lymphoma.

Methods

Fifty-two patients with a mean age of 24.2 years (range 15.5–44.4) at diagnosis monitored with FDG PET/CT to assess treatment response for Hodgkin’s lymphoma were selected for this retrospective analysis under an Institutional Review Board waiver. Of the patients, 26 were treated with a chemotherapy regimen known to cause prolonged and sometimes permanent azoospermia (BEACOPP—bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) and 26 with a regimen known to have a much milder effect on gonadal function (ABVD—doxorubicin, bleomycin, vincristine, and dacarbazine). Each patient underwent one FDG PET/CT before treatment and at least one FDG PET/CT after start of chemotherapy. In all examinations, FDG activity was measured in the testes with different quantification metrics: maximum standardized uptake value (SUVmax), SUVmean, functional volume (FV) and total testicular glycolysis (TTG), and blood pool activity determined (SUVmean).

Results

Testicular FDG uptake (SUVmax) was significantly associated with blood pool activity (p < 0.001). Furthermore, testicular FDG uptake metrics incorporating volume (e.g., FV and TTG) were associated with age. There was no significant change in SUVmax, SUVmean, FV, and TTG from the PET/CT at baseline to the PET/CTs over the course of chemotherapy either for patients treated with BEACOPP or for patients treated with ABVD.

Conclusion

For patients undergoing chemotherapy for Hodgkin’s lymphoma, there is a significant association between testicular FDG uptake and blood pool activity, but no significant changes in FDG uptake over the course of chemotherapy. Therefore, FDG uptake may not be a feasible surrogate marker for fertility monitoring in patients with Hodgkin’s lymphoma undergoing chemotherapy.

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Acknowledgments

We thank Joanne Kelvin for providing us with helpful insights regarding the impact of chemotherapy on fertility. Irene A. Burger was financially supported by the Prof. Dr. Max Cloëtta Foundation (Switzerland) and the Swiss Society of Nuclear Medicine.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Irene A. Burger, Hebert Alberto Vargas, Debra A. Goldman, Heiko Schöder & Hedvig Hricak

  2. Department of Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, New York, NY, 10065, USA

    Mithat Gonen

  3. Department of Medicine, Lymphoma Service, Memorial Sloan-Kettering Cancer Center, 1233 York Avenue, New York, NY, 10065, USA

    Anita Kumar & Andrew D. Zelenetz

Authors
  1. Irene A. Burger
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  2. Hebert Alberto Vargas
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  5. Anita Kumar
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  6. Andrew D. Zelenetz
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  7. Heiko Schöder
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  8. Hedvig Hricak
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Corresponding author

Correspondence to Hebert Alberto Vargas.

Additional information

Irene A. Burger and Hebert Alberto Vargas contributed equally to this paper.

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Burger, I.A., Vargas, H.A., Goldman, D.A. et al. The impact of systemic chemotherapy on testicular FDG activity in young men with Hodgkin’s lymphoma. Eur J Nucl Med Mol Imaging 40, 701–707 (2013). https://doi.org/10.1007/s00259-012-2335-1

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  • DOI: https://doi.org/10.1007/s00259-012-2335-1

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