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首页> 外文期刊>World journal of urology >The role of ((18)F) FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management.
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The role of ((18)F) FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management.

机译：（（18）F）FDG-PET，CT / MRI和肿瘤标志物动力学在转移性生殖细胞肿瘤化疗后残留质量评估中的作用-治疗前景。

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The purpose of this study was to assess the ability of [(18)F]FDG-PET, CT/MRI and serum tumor marker (TM) to predict the viability of residual masses after high-dose chemotherapy (HD-Ctx) in patients with metastatic germ cell tumors (GCT). In a prospective study, 60 residual tumors in 28 GCT patients were classified as viableonviable by FDG-PET, CT/MRI and TM levels. The results were validated either by histological examination of a resected mass and/or biopsy or by clinical/radiological follow-up for at least 6 months. There were no significant differences among the sensitivities observed with PET, CT/MRI and TM, but PET was significantly more specific than CT/MRI in predicting residual mass viability. TM showed the highest specificity. The highest accuracy in classification of residual tumors was achieved by a combination of PET, CT/MRI and TM (area under the ROC curve =0.91). All mature teratomas showed false-negative PET results with SUVs in the same range as necrosis. For classification of residual masses after HD-Ctx of metastatic GCT, [(18)F]FDG-PET is a valuable diagnostic method to complement the established procedures CT and TM. Positive PET results are highly correlated with the presence of viable tumor, but residual masses with negative PET findings still require resection. In cases of tumor progression diagnosed by CT and elevated TM, additional PET examinations are without benefit. PET seems useful in patients with stable disease or partial remission in CT/MRI and normalized TM as well as in marker-negative disease.
机译：这项研究的目的是评估[（18）F] FDG-PET，CT / MRI和血清肿瘤标志物（TM）预测患者大剂量化疗（HD-Ctx）后残余肿块的生存能力转移性生殖细胞肿瘤（GCT）。在一项前瞻性研究中，根据FDG-PET，CT / MRI和TM水平将28例GCT患者中的60例残留肿瘤分类为可生存/不可生存。通过对切除的肿块进行组织学检查和/或活检或通过临床/放射学随访至少6个月来验证结果。 PET，CT / MRI和TM所观察到的敏感性之间没有显着差异，但是PET在预测残余质量生存力方面比CT / MRI更具特异性。 TM显示出最高的特异性。通过结合PET，CT / MRI和TM（ROC曲线下的面积= 0.91）实现了对残留肿瘤分类的最高准确度。所有成熟的畸胎瘤在与坏死范围相同的SUV上均显示假阴性PET结果。对于转移性GCT的HD-Ctx术后残留质量的分类，[（18）F] FDG-PET是一种有价值的诊断方法，可以补充已建立的CT和TM程序。 PET阳性结果与存活的肿瘤高度相关，但PET阴性的残留肿块仍需切除。如果通过CT和TM升高诊断出肿瘤进展，则额外的PET检查无效。 PET似乎对疾病稳定或在CT / MRI和TM正常化以及标志物阴性疾病中部分缓解的患者有用。

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