Die Rolle der 18F-FDG-PET/CT in der Diagnostik von gonadalen und extragonadalen Keimzelltumoren des Mannes

Jörg Beyer; Richard Cathomas; Ali Afshar-Oromieh

doi:10.1055/a-1118-4683

Der Nuklearmediziner, Table of Contents

Der Nuklearmediziner 2020; 43(04): 327-331
DOI: 10.1055/a-1118-4683

Uroonkologie

Die Rolle der ¹⁸F-FDG-PET/CT in der Diagnostik von gonadalen und extragonadalen Keimzelltumoren des Mannes

The role of ¹⁸F-FDG-PET/CT in male gonadal and extragonadal germ-cell cancer

Jörg Beyer

¹Universitätsklinik für Medizinische Onkologie, Inselspital, Universitätsklinik der Universität Bern, Universität Bern, Freiburgstrasse, CH-3010 Bern, Schweiz

,

Richard Cathomas

²Departement Innere Medizin, Medizinische Onkologie und Hämatologie, Kantonsspital Graubünden, Loëstrasse 170, CH-7000 Chur, Schweiz

,

Ali Afshar-Oromieh

³Universitätsklinik für Nuklearmedizin, Inselspital, Universitätsklinik der Universität Bern, Universität Bern, Freiburgstrasse, CH-3010 Bern, Schweiz

› Author Affiliations

Abstract

Zusammenfassung

Gonadale Keimzelltumoren stellen zusammen mit den seltenen extragonadalen Keimzelltumoren die häufigste Krebserkrankung von Männern zwischen der Pubertät und einem Alter von etwa 40 Jahren dar. Diagnostik, Therapie und Nachsorge wurden in klinischen Studien intensiv untersucht sowie in nationalen und internationalen Leitlinien zusammengefasst [1] [2] [3]. Die überwiegende Mehrheit Betroffener wird heutzutage geheilt. Das junge Alter sowie die hohe Heilungsaussicht zwingen mehr noch als bei anderen Erkrankungen, unnötige Strahlenbelastung zu vermeiden. Daher bleibt der Einsatz der PET/CT bei Keimzelltumoren einigen wenigen Indikationen vorbehalten.

Abstract

Gonadal germ-cell cancer is together with the rare extragonadal germ-cell cancer the most common cancer in males from puberty until the age of around 40 years. Diagnosis, treatment and follow-up has been intensively studied in clinical trials and summarized in national and international guidelines. [1] [2] [3] The young age and the high cure rate make it ever more important to avoid unnecessary radiation exposure. Therefore, the use of PET/CT remains restricted to few and highly selected indications.

Schlüsselwörter

Keimzelltumoren - Diagnostik - PET/CT - Leitlinie

Key words

germ-cell cancer - diagnosis - PET/CT - guideline

Full Text

References

Literatur
1 Albers P, Albrecht W, Algaba F. et al. Guidelines on testicular cancer: 2015 update (2020). EurUrol; 2015 68. 1054-1068 Im Internet (abgerufen am: 25.07.2020): https://uroweb.org/guideline/testicular-cancer
2 Honecker F, Aparicio J, Berney D. et al. ESMO Consensus Conference on testicular germ cell cancer: diagnosis, treatment and follow-up. Ann Oncol 2018; 29: 1658-1686
3 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF). S3-Leitlinie Diagnostik, Therapie und Nachsorge der Keimzelltumoren des Hodens, Langversion 0.1 (Konsultationsfassung), AWMF Registernummer: 043/049OL. 2018 (abgerufen am: 25.07.2020) https://www.leitlinienprogramm-onkologie.de/leitlinien/hodentumoren
4 Schriefer P, Hartmann M, Oechsle K. et al. Positronenemissionstomographie bei Keimzelltumoren des Mannes. Urologe 2019; 58: 418-423
5 International Germ Cell Cancer Collaborative Group (IGCCCG). International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997; 15: 594-603
6 Kitajima K, Nakamoto Y, Senda M. et al. Normal uptake of 18F-FDG in the testis: an assessment by PET/CT. Ann Nucl Med 2007; 21: 405-410
7 Lassen U, Daugaard G, Eigtved A. et al. Whole-body FDG-PET in patients with stage I non-seminomatous germ cell tumours. Eur J Nucl Med Mol Imaging 2003; 30: 396-402
8 Huddart RA, O’Doherty MJ, Padhani A. et al. 18Fluorodeoxyglucose positron emission tomography in the prediction of relapse in patients with high-risk, clinical stage I nonseminomatous germ cell tumors: preliminary report of MRC trial TE22 — the NCRI Testis Tumour Clinical Study Group. J Clin Oncol 2007; 25: 3090-3095
9 Hain SF, O’Doherty MJ, Timothy AR. et al. Fluorodeoxyglucose PET in the initial staging of germ cell tumours. Eur J Nucl Med 2000; 27: 590-594
10 De Wit M, Brenner W, Hartmann M. et al. [18F]-FDG–PET in clinical stage I/II non-seminomatous germ cell tumours: results of the German multicenter trial. Ann Oncol 2008; 19: 1619-1623
11 Ambrosini V, Zucchini G, Nicolini S. et al. 18F-FDG PET/CT impact on testicular tumours clinical management. Eur J Nucl Med Mol Imaging 2014; 41: 668-673
12 Cook GJ, Sohaib A, Huddart RA. et al. The role of 18F-FDG PET/CT in the management of testicular cancers. Nucl Med Commun 2015; 36: 702-708
13 Kollmannsberger C, Oechsle K, Dohmen BM. et al. Prospective comparison of [18F]Fluorodeoxyglucose positron emission tomography with conventional assessment by computed tomography scans and serum tumor markers for the evaluation of residual masses in patients with nonseminomatous germ cell carcinoma. Cancer 2002; 94: 2353-2362
14 Spermon JR, De Geus-Oei LF, Kiemeney LALM. et al. The role of 18fluoro-2-deoxyglucose positron emission tomography in initial staging and re-staging after chemotherapy for testicular germ cell tumours. BJU Int 2002; 89: 549-556
15 Pfannenberg AC, Oechsle K, Bokemeyer C. et al. The role of [18F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors - prospects for management. World J Urol 2004; 22: 132-139
16 Oechsle K, Hartmann M, Brenner W. et al. [18F]Fluorodeoxyglucose positron emission tomography in nonseminomatous germ cell tumors after chemotherapy: the German multicenter positron emission tomographystudygroup. J Clin Oncol 2008; 26: 5930-5935
17 Motzer R, Bosl G, Heelan R. et al. Residual mass: an indication for further therapy in patients with advanced seminoma following systemic chemotherapy. J Clin Oncol 1987; 5: 1064-1070
18 De Santis M, Becherer A, Bokemeyer C. et al. 2-18fluoro-deoxy-D-glucose positron emission tomography is a reliable predictor for viable tumor in postchemotherapy seminoma: an update of the prospective multicentric SEMPETtrial. J Clin Oncol 2004; 22: 1034-1039
19 Bachner M, Loriot Y, Gross-Goupil M. et al. 2-18fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) for postchemotherapy seminoma residual lesions: a retrospective validation of the SEMPET trial. Ann Oncol 2012; 23: 59-64
20 Horwich A, Paluchowska B, Norman A. et al. Residual mass following chemotherapy of seminoma. Ann Oncol 1997; 8: 37-40
21 Cathomas R, Klingbiel D, Bernard B. et al. Questioning the value of fluorodeoxyglucose positron emission tomography for residual lesions after chemotherapy for metastatic seminoma: results of an international Global Germ Cell Cancer Group registry. J Clin Oncol 2018; 36: 3381-3387
22 Decoene J, Winter C, Albers P. False-positive fluorodeoxyglucose positron emission tomography results after chemotherapy in patients with metastatic seminoma. Urol Oncol 2015; 33: 23.e15-23.e21
23 Hain SF. et al. Fluorodeoxyglucose positron emission tomography in the evaluation of germ cell tumours at relapse. Br JCancer 2000; 83: 863-869