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Beurteilung von Residualtumoren nach Systemtherapie des metastasierten Seminoms

18F-2-Fluor-2-Deoxy-D-Glucose-Positronenemissionstomographie – Metaanalyse zur diagnostischen Wertigkeit

Assessment of residual tumours after systemic treatment of metastatic seminoma

18F-2-Fluoro-2-deoxy-D-glucose positron emission tomography – Meta-analysis of diagnostic value

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Zusammenfassung

Hintergrund

Metaanalyse zur Anwendung der 18F-2-Fluor-2-Deoxy-D-Glucose-Positronenemissionstomographie (FDG-PET) bei der Beurteilung von Residualtumorläsionen nach Chemotherapie bei Patienten mit reinem Seminom.

Material und Methoden

Es wurden 5 von 1999–2010 publizierte Arbeiten identifiziert, in denen bei insgesamt 130 Patienten nach Abschluss der Systemtherapie sowohl eine Schnittbildgebung mittels Computertomographie (CT) als auch mittels FDG-PET zur Residualtumordetektion durchgeführt wurde. Wir verglichen die FDG-PET mit der konventionellen CT (Tumorgröße ≤ oder >3 cm) hinsichtlich der Fähigkeit, sensitiv und spezifisch vitales Tumorgewebe zu identifizieren.

Ergebnisse

Die FDG-PET zeigte im Mittel eine höhere Spezifität (92% vs. 59%), Sensitivität (72% vs. 63%) sowie einen besseren positiv prädiktiven Wert im Vergleich zur CT-Beurteilung allein mittels Größenbestimmung des Residualtumors (70% vs. 28%). Auch bezüglich des negativ prädiktiven Wertes schien die PET tendenziell überlegen (93 vs. 86%).

Schlussfolgerung

Die FDG-PET ist angesichts der aktuell verfügbaren und hier ausgewerteten Daten hinsichtlich der Beurteilung von Residualläsionen nach Chemotherapie bei Patienten mit metastasiertem Seminom der CT bezüglich der Dektektion viabler Resttumoranteile überlegen und ihre Anwendung zu empfehlen.

Abstract

Background

Meta-analysis evaluating the accuracy and sensitivity of FDG (2-[18F]-fluoro-2-deoxy-D-glucose) positron emission tomography (PET) to predict viable residual tumours in patients with metastatic seminoma.

Material and methods

Altogether 5 studies with 130 patients were identified. Both FDG PET and the size of the residual lesions on conventional computed tomography (CT; lesions either ≤ or > 3 cm) were correlated with the presence or absence of viable residual tumour.

Results

The specificity (92 vs 59%), sensitivity (72 vs 63%), positive (70 vs 28%) and negative (93 vs 86%) predictive value of FDG PET were superior to data obtained by assessing residual tumour size (either ≤ or > 3 cm) applying CT scans alone.

Conclusion

In view of the data currently available, FDG PET seems to be a clinically useful predictor of viable tumour in post-chemotherapy residuals of pure seminoma.

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  1. Klinik für Urologie, Universitätsklinikum Ulm, Pritzwitzstraße 43, 89075, Ulm, Deutschland

    J. Müller, A.J. Schrader, F. Jentzmik & M. Schrader

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  1. J. Müller
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  2. A.J. Schrader
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  3. F. Jentzmik
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  4. M. Schrader
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Correspondence to J. Müller.

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Müller, J., Schrader, A., Jentzmik, F. et al. Beurteilung von Residualtumoren nach Systemtherapie des metastasierten Seminoms. Urologe 50, 322–327 (2011). https://doi.org/10.1007/s00120-010-2469-3

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  • DOI: https://doi.org/10.1007/s00120-010-2469-3

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