PET imaging in testicular tumours

Testicular cancer is rare, but its incidence is expected to rise. [18F] fluorodeoxyglucose ([18F]FDG) PET/computed tomography (CT) added role in testicular cancer management has been defined in a set of specific clinical settings. The current review focuses on recent advances in the employment of PET/CT in testicular cancer patients.

[18F]FDG PET/CT is not recommended for initial staging or for suspected testicular tumours. PET/CT role in testicular cancer management is mainly for the assessment of seminoma residual masses after therapy (>3 cm). Although [18F]FDG PET/CT has a very high negative predictive value, its positive predictive value varies across studies: appropriate PET/CT scheduling after therapy and a careful history are mandatory for accurate interpretation. Interim PET/CT could prove valuable to spare subsequent chemotherapy cycles in patients already in remission, reducing related toxicity. The role of [18F]FDG in nonseminoma tumours is hampered by the low sensitivity in teratoma.

[18F]FDG PET/CT is currently used for the assessment of seminoma residual masses (>3 cm) after therapy. A negative PET could also spare unnecessary further chemotherapy cycles in responding patients, reducing toxicity. Although rare, testicular secondary lesions can be detected with non[18F]FDG tracers when PET/CT is performed for other primary tumours.