Diagnostic Applications of Nuclear Medicine: Testicular Cancer

Abstract

Testicular cancer is the most common solidnon hematological cancer diagnosed in young adult men. Personal history of testicular cancer is a major risk factor for developing testicular cancer. Testicular germ cell tumors are the most common tumors, these are further divided into seminomas and non seminomatous germ cell tumors. Tumors generally present as painless testicular mass, the first investigation is testicular ultrasound followed by serum biomarkers. MRI can be used as a problem solver only in equivocal cases. Radical orchiectomy provides therapy as well as pathological T staging. CT scan is the primary investigation for assessing lymph node status and for evaluation of distant metastasis. [ 18 F]FDG PET/CT is not recommended for diagnosis of primary testicular cancer with reported unsatisfactory negative predictive value, nevertheless PET/ CT offers several advantages over CT particularly for patients with equivocal CT findings and in patients who exhibit elevated tumor markers and negative CT scan. In addition, [ 18 F]FDG PET/CT is especially useful for evaluation of post chemotherapy residual masses in metastatic seminoma. [ 18 F]FDG PET/CT is, however; not routinely indicated for post chemotherapy evaluation of non seminomatous germ cell tumors because of high false negative rate in Teratomas.