It was difficult to determine the metastatic potential of suspicious retroperitoneal nodes in testicular cancer using standard imaging. For a study, researchers analyzed new data on the use of innovative imaging modalities to evaluate live testicular cancer nodal metastases. The lymphatic metastatic progression of testicular germ cell tumors (TCGTs) to the retroperitoneum was expected. As a result, retroperitoneal imaging was essential for staging, monitoring therapy response, and determining recurrence. Traditional computed tomography (CT) imaging is useful for detecting pathologically enlarged lymph nodes, but it lacks the molecular information needed to evaluate whether suspicious nodes house live malignancy. Positron emission tomography (PET) using the metabolic radiotracer 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG or FDG) had been demonstrated to be beneficial in identifying the presence or absence of live tumor following treatment for seminoma, but its relevance in non-seminomatous germ cell tumors (NSGCTs) and other clinical settings was limited. Patients with persistent masses following NSGCT treatment provided a challenging problem since surgical removal was associated with significant morbidity, despite the fact that many patients simply had fibrosis on final histology. On preoperative imaging, current imaging modalities could not distinguish between fibrosis and live tumor. Novel molecular imaging approaches provided excellent prospects for improving diagnosis in these patients. 

Although new imaging systems had the potential to increase the capacity to identify viable nodal metastases regardless of size or shape, confirmation studies were still lacking.