CT Followup for Testicular Cancer – pro
There is a difference of opinion between European and American guidelines regarding routine CT scanning for surveillance. ESMO recommends clinical review, chest X-ray and tumor markers monthly for 2 year, 2 monthly for the 2nd year, then 6monthly to 5 years and then annually and CT scans only as clinically indicated. Similar recommendation was made in the Netherlands. On the other hand, in the USA the NCCN recommends abdomino- pelvic CT every 2-3 months in the first year and 6-12 months in the 2nd years. Thereafter it is every 12 months until year 6+ when it is 12-24mo. This is for non-seminoma. For seminoma it is somewhat different but similar (TEST-12). It does not recomend routine chest CT scans. Per the NCCN guideline, on TEST-16, surveillance is not recommended after 5 years and not with MRI, only CR scans and chest X-ray
After RPLND, NCCN accepts chest CT as clinically indicated.
PET or MRI is not recommended for surveillance by NCCN or any other guideline to my knowledge.
NCCN TEST-16, 2020
https://www.auanet.org/guidelines/testicular-cancer-guideline, 2019
Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Horwich A, Laguna MP. Guidelines on testicular cancer. Arnhem, The Netherlands: European Association of Urology (EAU); 2008 Mar. 54 p. [35 references]