Residual Masses Post Chemotherapy in Germ Cell Tumors: Role of Fluorodeoxyglucose Positron Emission Tomography Scans

Abstract

Background: The standard treatment for patients with advanced germ cell tumor is 3–4 cycles of chemotherapy. Post therapy a significant number of patients have residual radiographic abnormalities. Resection of this mass depends on the histology. Those patients with viable cancer will require additional chemotherapy. An imaging study that may identify viable cancer in residual tumor is being evaluated with a Fluro-2-deoxy-D-glucose positron emission tomography (FDG PET) scan. Methods: Thirteen patients with metastatic germ cell tumors who were treated with chemotherapy who had residual abnormalities on CT scan were evaluable. They underwent a PET scan and had surgical resection. The pathological specimens were correlated with the findings on the PET scan. Results: Five patients had a positive PET scan, and eight had no uptake on a PET scan. Ten patients had pathological tissue available for correlation. The overall sensitivity and specificity of a PET scan in evaluating residual masses were 62 and 100%, respectively. Conclusion: PET imaging has limited utility in the management of patients with residual germ cell tumors.