Einerhand, Sarah M. H. and Zuur, Lotte G. and Wondergem, Maurits J. and Boellaard, Thierry N. and Barwari, Kurdo and van Leeuwen, Pim J. and van Rhijn, Bas W. G. and Mertens, Laura S. (2023) The Implementation of FDG PET/CT for Staging Bladder Cancer: Changes in the Detection and Characteristics of Occult Nodal Metastases at Upfront Radical Cystectomy? JOURNAL OF CLINICAL MEDICINE, 12 (10): 3367. ISSN , 2077-0383
Full text not available from this repository. (Request a copy)Abstract
Occult lymph node (LN)-metastases are frequently found after upfront radical cystectomy (uRC) for bladder cancer (BC). We evaluated whether the implementation of 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG PET/CT) influenced nodal staging at uRC. All consecutive BC patients who underwent uRC with bilateral pelvic lymph node dissection (PLND) were identified and divided into two cohorts: cohort A consisted of patients staged with FDG PET/CT and contrast-enhanced CT (CE-CT) (2016-2021); cohort B consisted of patients staged with CE-CT only (2006-2011). The diagnostic performance of FDG PET/CT was assessed and compared with that of CE-CT. Thereafter, we calculated the occult LN metastases proportions for both cohorts. In total, 523 patients were identified (cohort A n = 237, and cohort B n = 286). Sensitivity, specificity, PPV and NPV of FDG PET/CT for detecting LN metastases were 23%, 92%, 42%, and 83%, respectively, versus 15%, 93%, 33%, 81%, respectively, for CE-CT. Occult LN metastases were found in 17% of cohort A (95% confidence interval (CI) 12.2-22.8) and 22% of cohort B (95% CI 16.9-27.1). The median size of LN metastases was 4 mm in cohort A versus 13 mm in cohort B. After introduction of FDG PET/CT, fewer and smaller occult LN metastases were present after uRC. Nevertheless, up to one-fifth of occult (micro-)metastases were still missed.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY; NEOADJUVANT CHEMOTHERAPY; CARCINOMA; bladder cancer; urothelial carcinoma; imaging; staging; CT; FDG PET/CT; radical cystectomy; neoadjuvant chemotherapy; lymph node; metastasis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Mar 2024 15:15 |
| Last Modified: | 16 Mar 2024 15:15 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60265 |
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