Cancer Res Treat.  2015 Oct;47(4):834-843. 10.4143/crt.2014.157.

Detecting Metastatic Bladder Cancer Using 18F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography

• Ozturk H

• KMID: 2403403
• DOI: http://doi.org/10.4143/crt.2014.157

Abstract

PURPOSE
The purpose of this study was to retrospectively investigate the contribution of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) to detection of metastatic bladder cancer.
MATERIALS AND METHODS
The present study included 79 patients (69 men and 10 women) undergoing 18F-FDG-PET/CT upon suspicion of metastatic bladder cancer between July 2007 and April 2013. The mean age was 66.1 years with a standard deviation of 10.7 years (range, 21 to 85 years). Patients were required to fast for 6 hours prior to scanning, and whole-body PET scanning from the skull base to the upper thighs was performed approximately 1 hour after intravenous injection of 555 MBq of 18F-FDG. Whole body CT scanning was performed in the cranio-caudal direction. FDG-PET images were reconstructed using CT data for attenuation correction. Suspicious recurrent or metastatic lesions were confirmed by histopathology or clinical follow-up.
RESULTS
The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-FDG-PET/CT were 89%, 78%, 90%, 75%, and 86%, respectively.
CONCLUSION
18F-FDG-PET/CT can detect metastases with high sensitivity and positive predictive values in patients with metastatic bladder carcinoma.

Keyword

Urinary bladder neoplasms; Neoplasm metastasis; Positron emission tomography; X-ray computed tomography

MeSH Terms

Fluorodeoxyglucose F18
Follow-Up Studies
Humans
Injections, Intravenous
Male
Neoplasm Metastasis
Positron-Emission Tomography
Retrospective Studies
Sensitivity and Specificity
Skull Base
Thigh
Tomography, X-Ray Computed
Urinary Bladder Neoplasms*
Urinary Bladder*
Fluorodeoxyglucose F18

Figure

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  Fig. 1. Distribution of metastases of patients. UTUC, upper tract urothelial carcinoma.

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  Fig. 2. (A) Coronal 18F-FDG-PET/CT scans (white arrow: right lung metastasis; SUVmax, 14.6; red arrow: false-positive FDG accumulation in the left lung, pneumonia; SUVmax, 5.0). (B) Coronal 18F-FDG-PET/CT scans (arrow: liver metastasis; SUVmax, 6.4). (C) Coronal 18F-FDG-PET/CT scans (arrow: metastatic mass filling the neural foramina at the level of L2 vertebra; SUVmax, 12.0). 18F-FDG-PET/CT, fluorodeoxyglucose-positron emission tomography/computed tomography; SUVmax, maximum standardized uptake value.

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  Fig. 3. (A) Axial 18F-FDG-PET/CT scans (arrow: false-positive FDG accumulation in the left lung, pneumonia; SUVmax, 5.0). (B) Axial 18F-FDG-PET/CT scans (arrow: right lung metastasis; SUVmax, 14.6). (C) Axial 18F-FDG-PET/CT scans (arrow: liver metastasis; SUVmax, 6.4). (D) Axial 18F-FDG-PET/CT scans (arrow: metastatic mass filling the neural foramina at the level of L2 vertebra; SUVmax, 12.0). 18F-FDG-PET/CT, fluorodeoxyglucose-positron emission tomography/computed tomography; SUVmax, maximum standardized uptake value.

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  Fig. 4. (A) Maximum intensity projection (MIP) images of a patient (blue arrow: right lung metastasis; red arrow: false-positive fluorodeoxyglucose accumulation in the left lung, pneumonia). (B) MIP images of a patient (arrow: L2 vertebral metastasis).

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  Fig. 5. (A) Coronal 18F-FDG-PET/CT scans (arrow: widespread retroperitoneal lymph node metastasis; SUVmax, 20.3). (B) MIP images of a patient (arrow: widespread retroperitoneal lymph node metastasis). (C) Coronal 18F-FDG-PET/CT scans (arrow: soft tissue metastasis; SUVmax, 18.2). (D) MIP images of a patient (arrow: soft tissue metastasis). 18F-FDG-PET/CT, fluorodeoxyglucose-positron emission tomography/computed tomography; SUVmax, maximum standardized uptake value; MIP, maximum intensity projection.

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  Fig. 6. (A) Coronal 18F-FDG-PET/CT scans (arrow: widespread conglomerate retroperitoneal lymph node metastasis; SUVmax, 10.8). (B) MIP images of a patient (arrow: widespread conglomerate retroperitoneal lymph node metastasis). (C) Coronal 18F-FDG-PET/CT scans (arrows: widespread bone metastasis; SUVmax, 13.5). (D) MIP images of a patient (arrows: widespread bone metastasis). 18F-FDG-PET/CT, fluorodeoxyglucose-positron emission tomography/computed tomography; SUVmax, maximum standardized uptake value; MIP, maximum intensity projection.

Reference

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