The impact of systemic chemotherapy on testicular FDG activity in young men with Hodgkin's lymphoma Journal Article

Authors: Burger, I. A.; Vargas, H. A.; Goldman, D. A.; Gonen, M.; Kumar, A.; Zelenetz, A. D.; Schöder, H.; Hricak, H.
Article Title: The impact of systemic chemotherapy on testicular FDG activity in young men with Hodgkin's lymphoma
Abstract: Based on prior reports suggesting a positive correlation between fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/CT and total sperm count and concentration, we sought to identify changes in testicular FDG uptake over the course of chemotherapy in young men with Hodgkin's lymphoma. Fifty-two patients with a mean age of 24.2 years (range 15.5-44.4) at diagnosis monitored with FDG PET/CT to assess treatment response for Hodgkin's lymphoma were selected for this retrospective analysis under an Institutional Review Board waiver. Of the patients, 26 were treated with a chemotherapy regimen known to cause prolonged and sometimes permanent azoospermia (BEACOPP--bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) and 26 with a regimen known to have a much milder effect on gonadal function (ABVD--doxorubicin, bleomycin, vincristine, and dacarbazine). Each patient underwent one FDG PET/CT before treatment and at least one FDG PET/CT after start of chemotherapy. In all examinations, FDG activity was measured in the testes with different quantification metrics: maximum standardized uptake value (SUVmax), SUVmean, functional volume (FV) and total testicular glycolysis (TTG), and blood pool activity determined (SUVmean). Testicular FDG uptake (SUVmax) was significantly associated with blood pool activity (p < 0.001). Furthermore, testicular FDG uptake metrics incorporating volume (e.g., FV and TTG) were associated with age. There was no significant change in SUVmax, SUVmean, FV, and TTG from the PET/CT at baseline to the PET/CTs over the course of chemotherapy either for patients treated with BEACOPP or for patients treated with ABVD. For patients undergoing chemotherapy for Hodgkin's lymphoma, there is a significant association between testicular FDG uptake and blood pool activity, but no significant changes in FDG uptake over the course of chemotherapy. Therefore, FDG uptake may not be a feasible surrogate marker for fertility monitoring in patients with Hodgkin's lymphoma undergoing chemotherapy.
Keywords: adolescent; adult; retrospective studies; young adult; prednisone; doxorubicin; pathophysiology; positron emission tomography; antineoplastic agent; metabolism; dacarbazine; computer assisted tomography; etoposide; antineoplastic combined chemotherapy protocols; tomography, x-ray computed; cyclophosphamide; vincristine; drug effect; retrospective study; procarbazine; vinblastine; hodgkin disease; diagnostic agent; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; positron-emission tomography; scintiscanning; bleomycin; testis; biological transport; spermatozoon count; transport at the cellular level; multimodal imaging; sperm count; humans; human; male; article
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 40
Issue: 5
ISSN: 1619-7070
Publisher: Springer  
Date Published: 2013-05-01
Start Page: 701
End Page: 707
Language: English
PUBMED: 23389428
PROVIDER: scopus
PMCID: PMC4004336
DOI: 10.1007/s00259-012-2335-1
Notes: Export Date: 3 February 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Mithat Gonen
    716 Gonen
  2. Heiko Schoder
    289 Schoder
  3. Andrew D Zelenetz
    556 Zelenetz
  4. Hedvig Hricak
    333 Hricak
  5. Anita Kumar
    52 Kumar
  6. Debra Alyssa Goldman
    97 Goldman
  7. Irene Andrea Burger
    10 Burger