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[Is lymphography still relevant in seminoma?]
M van Kampen1, P Andreas, H Renner
1Abteilung Strahlentherapie des Klinikums Nürnberg.
Summary
Computed tomography (CT) scans can replace lymphography for staging testicular seminoma in most cases. However, lymphography may still be beneficial for specific treatment adjustments, especially when reducing radiation therapy volumes or doses.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Lymphography and computed tomography (CT) scans are used for staging and therapy planning in testicular seminoma.
- The study aimed to determine if CT scans could replace lymphography.
Purpose of the Study:
- To compare the efficacy of lymphography and CT scans in staging testicular seminoma.
- To evaluate the impact of imaging results on radiotherapy treatment planning.
Main Methods:
- Retrospective analysis of 114 patients with testicular seminoma treated with radiotherapy.
- Radiological staging performed using both lymphography and CT scans for all patients.
- Comparison of imaging results and their influence on treatment decisions.
Main Results:
- Lymphography and CT scans yielded similar results in 79% of patients.
- CT scans upstaged 4% of patients with negative lymphograms.
- Lymphograms identified positive findings in 17% of patients with negative CT scans.
- Treatment plans were altered in 21% of patients based on imaging results.
- CT scans could not reliably identify Stage IIa micrometastasis, while lymphography could, albeit with high false positive rates.
Conclusions:
- CT scans can supersede lymphography in conventional testicular seminoma radiotherapy (para-aortal/iliac region, ~30 Gy HD).
- Lymphography should be considered alongside CT scans when reducing treatment volume or dose for testicular seminoma.