Einerhand, Sarah M. H. and Voskuilen, Charlotte S. and van de Putte, Elies E. Fransen and Donswijk, Maarten L. and Bruining, Annemarie and van Der Heijden, Michiel S. and Mertens, Laura S. and Hendricksen, Kees and Vegt, Erik and van Rhijn, Bas W. G. (2023) Prospective Evaluation of FDG-PET/CT for On-treatment Assessment of Response to Neoadjuvant or Induction Chemotherapy in Invasive Bladder Cancer. BLADDER CANCER, 9 (1). pp. 49-57. ISSN 2352-3727, 2352-3735
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: Neoadjuvant/induction chemotherapy (NAIC) improves survival in patients with muscle-invasive bladder carcinoma (MIBC). On-treatment response assessment may aid in decisions to continue or cease NAIC. OBJECTIVE: We investigated whether 18F-fluoro-2-deoxy-D-glucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT) could predict response to NAIC and compared to contrast-enhanced Computed Tomography (CECT). METHODS: We prospectively included 83 patients treated forMIBC(i.e. high-risk cT2-4N0M0 or cT1-4N+M0-1a) between 2014 and 2018. Response to NAIC was assessed after 2-3 cycles with FDG-PET/CT (Peter-Mac and EORTC criteria) and CECT (RECIST1.1 criteria). We assessed prediction of complete pathological response (pCR; ypT0N0), complete pathological down-staging (pCD;= ypT1N0), any down-staging from baseline (ypTN < cTN) and progression (inoperable tumor/ypN+/M+). The reference standard was histopathological assessment or clinical follow-up. Sensitivity, specificity, and accuracy were calculated. RESULTS: Pathological response rates were 21% for pCR, 29% for pCD, and 10% progressed. All patients underwent FDG-PET/CT and 61 patients also underwent CECT (73%). Accuracy of FDG-PET/CT for prediction of pCR, pCD, and progression were 73%, 48%, and 73%, respectively. Accuracy of CECT for prediction of pCR, pCD, and progression were 78%, 65%, and 67%, respectively. Specificity of CECT was significantly higher than FDG-PET/CT for prediction of pCD and any down-staging (p = 0.007 and p = 0.022). In all other analyses, no significant differences between FDG-PET/CT and CECT were found. CONCLUSIONS: Routine FDG-PET/CT has insufficient predictive power to aid in response assessment compared to CECT.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSITRON-EMISSION-TOMOGRAPHY; RADICAL CYSTECTOMY; SURVIVAL; CISPLATIN; Bladder cancer; imaging; urothelial carcinoma; lymph-node; metastasis; fluorodeoxyglucose F18; Positron emission tomography (PET); computed tomography (CT) |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Mar 2024 09:37 |
| Last Modified: | 23 Mar 2024 09:37 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60409 |
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