Evaluation of fluorodeoxyglucose positron‐emission tomography with computed tomography for staging of urothelial carcinoma

Abstract

histopathology was used as the reference standard to compare the sensitivity and specificity of FDG-PET/CT and standard CT in detecting UBC and pelvic lymph node metastasis. Furthermore, 36 patients with ≥ 6 months of follow-up imaging were considered to describe the progression of UC and extrapelvic positive FDG-PET/CT images. RESULTSFor the detection of primary UBC, FDG-PET/ CT was slightly more sensitive than CT (85% vs 77%) but less specific (25% vs 50%). For the detection of pelvic node metastasis FDG-PET/CT was more sensitive than CT (57% vs 33%) with a specificity of 100% for both imaging techniques. In 20 patients, extrapelvic FDG-PET/CT images showed suspected disease at the first evaluation. UC progressed in nine of the 10 patients who had synchronous multiple PET-positive retroperitoneal or mediastinal lymph nodes, and in only two of the nine with unique hyperactive lesions in the lung. FDG-PET/CT also detected a pT1G3 UC of the renal pelvis and all bone metastases detected by bone scintigraphy. CONCLUSIONSFDG-PET/CT could replace standard CT and bone scintigraphy in the presurgical staging and monitoring of patients with UC after surgery or chemotherapy.

18F‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study

“…The diagnostic performances of 18 F-FDG PET-CT for lymph node staging and/or detection of distant metastases in bladder cancer are better than those of standard CT. [23][24][25] There is no statistical testing to compare sensibility and specificity difference between 18 F-FDG PET-CT and CT, but all results were in favor of 18 F-FDG PET-CT. A recent meta-analysis showed high specificity (89%) and sensitivity (82%) of 18 F-FDG PET-CT for staging or restaging (metastatic lesions) of bladder cancer. 26 However, few published series have assessed the value of 18 F-FDG PET-CT for the precise diagnosis of lymph node invasion.…”

Prognostic Value of ¹¹C-Choline PET/CT and CT for Predicting Survival of Bladder Cancer Patients Treated with Radical Cystectomy

“…Over the last few years PET/CT with the tracers 18 F-FDG, 11 C-choline or 11 C-acetate has evolved as a new staging modality combining cross-sectional anatomical and functional imaging [13,14,15,16,17,18,19,20,21,22,23,24,25,26]. Several studies described increased accuracy and high specificity rates especially in the detection of lymph nodes or distant metastases to bone and visceral organs with 18 F-FDG-based [13,16,17,19,20], 11 C-choline-based [14,24,37] or 11 C-acetate-based [24] PET/CT, which had an impact on further clinical management in a significant number of patients.…”

“…Recently, positron emission tomography (PET) as functional imaging with tracers like 18 F-FDG, 11 C-choline or 11 C-acetate in combination with CT has been introduced [13,14,15,16,17,18,19,20,21,22,23,24,25,26]. However, these studies present conflicting data as to whether these new imaging modalities are able to improve clinical staging in comparison to results of the ‘gold standard' histopathology.…”

The Role of Radiology in Perivesical Invasion of Muscle-Invasive Bladder Cancer

“…Karbon (C) kolin veya C-methionin gibi mesaneye ekskresyonu daha az olan diğer radyoizotoplar ile yapılan çalışmalarda primer tümör gösterilebilmekte ise de bu radyoizotopların tanıya ve evrelemeye katkısı gösterilememiştir (8,11,20). PET-BT ile yapılan çalışmalar göstermiştir ki mesane kanseri nodal evrelemesinde kontrastlı BT'ye göre üstünlüğünü, primer tümör tanısında ve lokal evrelemede gösterememektedir (21,22,23).…”