Positron Emission Tomography in the Diagnosis and Staging of Urinary Bladder Cancer

Åhlström, Håkan; Malmström, Per‐Uno; Letocha, Henry; Andersson, Jan; Långström, Bengt; Nilsson, Sven Erik G.

doi:10.1177/02841851960371p137

Cited by 73 publications

(40 citation statements)

References 9 publications

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“…Because an accumulation of 18 F-FDG in the urine interferes with visualization of pelvic and abdominal abnormalities, radiologists or oncologists occasionally need to empty patients' bladders before the PET scan (19) or even to retrograde-irrigate the urinary bladder with saline and a Foley catheter before or during PET data acquisition (20,21). To avoid such an invasive procedure, doctors also have used diuretics in an effort to reduce 18 F-FDG activity in the urinary tract and reported improved diagnostic accuracy for 18 F-FDG PET in abdominopelvic malignancies (12).…”

Section: Figure 2 (A)mentioning

confidence: 99%

Elevated ¹⁸F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan

2013

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Angiotensin II receptor blockers (ARBs) are a common treatment for hypertensive patients but affect renal function. In this study, the effects of ARB on 18 F-FDG distribution and excretion were examined in mice treated with telmisartan at different doses. Methods: Male C57BL/6J mice were given telmisartan (low-dose group, 0.33 mg/kg/d; moderate-dose group, 0.66 mg/kg/d; high-dose group, 3 mg/kg/d) mixed in a high-fat diet for 20 wk. Mice on a telmisartanfree diet served as the control. At designated time points, the mice were injected with 18 F-FDG (18.5 MBq/mouse, n 5 5-10/time point for each group) to examine its biodistribution. Autoradiography using kidney sections was performed to visualize 18 F-FDG excretion. Plasma blood urea nitrogen (BUN) and creatinine levels were also measured to evaluate renal function. Results: Twenty-week telmisartan treatment significantly and dose-dependently increased 18 F-FDG levels in the blood (percentage injected dose per gram of tissue normalized by animal body weight: low, 0.13 6 0.03 [P , 0.0083]; moderate, 0.15 6 0.01 [P , 0.0083]; high, 0.15 6 0.03 [P , 0.0083], vs. control, 0.09 6 0.01). Significantly increased 18 F-FDG levels in organs were observed in mice in the moderate-and high-dose groups but not in the low-dose group. The plasma BUN and creatinine levels also dose-dependently increased, but they were within the reference ranges (for BUN: low, 27.00 6 4.42 mg/dL; moderate, 28.40 6 2.70 mg/dL; high, 39.22 6 6.91 mg/dL [P , 0.0083], vs. control, 22.40 6 2.80 mg/dL. For creatinine: low, 0.28 6 0.11 mg/dL; moderate, 0.40 6 0.07 mg/dL [P , 0.0083]; high, 0.51 6 0.09 mg/dL [P , 0.0083], vs. control, 0.18 6 0.04 mg/dL). The blood 18 F-FDG level positively correlated with plasma BUN (r 5 0.48, P , 0.01) and creatinine (r 5 0.61, P , 0.01) levels. The 18 F-FDG levels in the blood and organs returned to baseline 3 wk after cessation of telmisartan treatment. Autoradiography indicated that renal 18 F-FDG excretion was attenuated by telmisartan treatment and was reversed after treatment cessation. Conclusion: 18 F-FDG levels in the blood and organs were significantly increased by telmisartan treatment, indicating a potential increase in background activity on PET imaging of patients treated with ARBs. Our findings indicate the need for a careful assessment of 18 F-FDG uptake in patients treated with ARBs. A brief cessation of ARB treatment may be a potential method to avoid these effects and solve this problem.

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Section: Figure 2 (A)mentioning

confidence: 99%

Elevated ¹⁸F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan

2013

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“…Some investigators have attempted to achieve this and improve the sensitivity of PET by using furosemide injection before image acquisition, or retrograde bladder irrigation with a double-lumen Foley catheter, or postvoid images or other tracers; however, their results have been disappointing (11,(16)(17)(18)(19).…”

mentioning

confidence: 99%

18F-FDG PET/CT Delayed Images After Diuretic for Restaging Invasive Bladder Cancer

Anjos¹,

Etchebehere²,

Ramos³

et al. 2007

Journal of Nuclear Medicine

159

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PET with 18 F-FDG has been considered of limited value for detection of bladder cancer because of the urinary excretion of the tracer. The purpose of this study was to investigate the role of PET/CT in the detection and restaging of bladder cancer using furosemide and oral hydration to remove the excreted 18 F-FDG from the bladder. Methods: Seventeen patients with bladder cancer (11 without cystectomy, 6 with total cystectomy and urinary diversion) underwent 18 F-FDG PET/CT from head to the upper thighs 60 min after the intravenous injection of 370 MBq of 18 F-FDG. Additional pelvic images were acquired 1 h after the intravenous injection of furosemide and oral hydration. PET/CT findings were confirmed by MRI, cystoscopy, or biopsy. Results: PET/CT was able to detect bladder lesions in 6 of 11 patients who had not undergone cystectomy. These images changed the PET/ CT final reading in 7 patients: Recurrent bladder lesions were detected in 6 patients, pelvic lymph node metastases in 2 patients, and prostate metastasis in 1. This technique overcame the difficulties posed by the urinary excretion of 18 F-FDG. Hypermetabolic lesions could be easily detected by PET and precisely localized in the bladder wall, pelvic lymph nodes, or prostate by CT. Seven of 17 patients (41%) were upstaged only after delayed pelvic images. Conclusion: Detection of locally recurrent or residual bladder tumors can be dramatically improved using 18 F-FDG PET/CT with delayed images after a diuretic and oral hydration.

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“…The same group evaluated the utility of 11 C-methionine PET in the diagnosis and staging of urinary bladder carcinoma in a cohort of 23 patients. Eighteen of 23 primary tumors were detected on 11 C-methionine PET; moreover, tracer uptake levels were shown to be positively correlating with tumor stage (38).…”

Section: Positron Emission Tomography (Pet)mentioning

confidence: 97%

Imaging of bladder cancer: update on current approaches for diagnosis

Türkbey

Ravizzini

et al. 2011

Journal of the Belgian Society of Radiology

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Positron Emission Tomography in the Diagnosis and Staging of Urinary Bladder Cancer

Abstract: It is possible to visualize urinary bladder tumours larger than 1 cm in diameter with PET using (11)C-methionine, but the value of the method in the staging of the lesions is not superior to conventional methods.

Cited by 73 publications

References 9 publications

Elevated ¹⁸F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan

Elevated ¹⁸F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan

18F-FDG PET/CT Delayed Images After Diuretic for Restaging Invasive Bladder Cancer

Imaging of bladder cancer: update on current approaches for diagnosis

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Positron Emission Tomography in the Diagnosis and Staging of Urinary Bladder Cancer

Abstract: It is possible to visualize urinary bladder tumours larger than 1 cm in diameter with PET using (11)C-methionine, but the value of the method in the staging of the lesions is not superior to conventional methods.

Cited by 73 publications

References 9 publications

Elevated 18F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan

Elevated 18F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan

18F-FDG PET/CT Delayed Images After Diuretic for Restaging Invasive Bladder Cancer

Imaging of bladder cancer: update on current approaches for diagnosis

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Resources

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Elevated ¹⁸F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan

Elevated ¹⁸F-FDG Levels in Blood and Organs After Angiotensin II Receptor Blocker Administration: Experiment in Mice Administered Telmisartan