MP01-12 ACCURACY OF FDG-PET SCAN IN PRIMARY TESTICULAR SEMINOMA: ANALYSIS FROM SEMS TRIAL

You have accessJournal of UrologyPenile & Testicular Cancer I (MP01)1 May 2024MP01-12 ACCURACY OF FDG-PET SCAN IN PRIMARY TESTICULAR SEMINOMA: ANALYSIS FROM SEMS TRIAL Brian R. Hu, Muhannad Alsyouf, Clint Cary, Timothy Masterson, Lawrence Einhorn, Nabil Adra, Stephen Boorjian, Christian Kollmannsberger, Anne Schuckman, Alan So, Peter Black, Aditya Bagrodia, Eila Skinner, Mehrdad Alemozaffar, Timothy Brand, Scott Eggener, Phillip Pierorazio, Kelly Stratton, Lucia Nappi, Craig Nichols, and Siamak Daneshmand Brian R. HuBrian R. Hu , Muhannad AlsyoufMuhannad Alsyouf , Clint CaryClint Cary , Timothy MastersonTimothy Masterson , Lawrence EinhornLawrence Einhorn , Nabil AdraNabil Adra , Stephen BoorjianStephen Boorjian , Christian KollmannsbergerChristian Kollmannsberger , Anne SchuckmanAnne Schuckman , Alan SoAlan So , Peter BlackPeter Black , Aditya BagrodiaAditya Bagrodia , Eila SkinnerEila Skinner , Mehrdad AlemozaffarMehrdad Alemozaffar , Timothy BrandTimothy Brand , Scott EggenerScott Eggener , Phillip PierorazioPhillip Pierorazio , Kelly StrattonKelly Stratton , Lucia NappiLucia Nappi , Craig NicholsCraig Nichols , and Siamak DaneshmandSiamak Daneshmand View All Author Informationhttps://doi.org/10.1097/01.JU.0001008660.87408.90.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: pN0 rates after primary RPLND for testicular seminoma range from 9-16% in clinical trials. Limited prospective data exists on the accuracy of Positron Emission Tomography (PET) in Stage II testicular seminoma. We utilized a SEMS trial (Surgery in Early Metastatic Seminoma) radiographic correlate to evaluate the accuracy of PET scans to detect retroperitoneal metastasis. METHODS: The SEMS trial was a phase II prospective trial evaluating efficacy of RPLND in patients with testicular seminoma and limited retroperitoneal lymphadenopathy. F-18 FDG PET scanning was performed as an optional study in addition to standard axial imaging prior to surgery. The lymph node size, lymph node number, maximal Standardized Uptake Value (SUV), other radiographic findings were compared with the operative report and pathology report. The interpretation of the PET scan positivity was based upon local radiology from a tertiary care facility. RESULTS: Of the 55 patients enrolled in the trial, 26 (47%) had a PET scan performed at an average of 22 days (range 1-90) prior to surgery. Twenty PET scans were positive (77%), with eighteen of these having pathologically positive lymph nodes (PPV 90%). The average SUV of the positive lymph nodes was 7.0 (range 2.6-18.8). In the two patients who had false positive scans, one had nodes with mild reactivity (SUV 4) and one had an avid lesion that was thought to favor metastasis over being a ureter. In those with positive PET scans and positive pathologic lymph nodes, PET scan accurately identified the number of positive lymph nodes only 50% of the time. Six PET scans were negative with five of these patients having confirmed pN0 disease (NPV 83%). CONCLUSIONS: In patients with testicular seminoma and low-volume retroperitoneal adenopathy, PET scans may have a role in improving the accuracy of staging, though larger studies are necessary. PET scan does not accurately determine the number of positive lymph nodes. Source of Funding: Think Different Foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e6 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Brian R. Hu More articles by this author Muhannad Alsyouf More articles by this author Clint Cary More articles by this author Timothy Masterson More articles by this author Lawrence Einhorn More articles by this author Nabil Adra More articles by this author Stephen Boorjian More articles by this author Christian Kollmannsberger More articles by this author Anne Schuckman More articles by this author Alan So More articles by this author Peter Black More articles by this author Aditya Bagrodia More articles by this author Eila Skinner More articles by this author Mehrdad Alemozaffar More articles by this author Timothy Brand More articles by this author Scott Eggener More articles by this author Phillip Pierorazio More articles by this author Kelly Stratton More articles by this author Lucia Nappi More articles by this author Craig Nichols More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement PDF downloadLoading ...