van Ginkel, Noor and van Gennep, Erik J. and Oosterbaan, Liselot and Greidanus, Joyce and Boellaard, Thierry N. and Wondergem, Maurits and Vis, Andre N. and de Reijke, Theo M. and van Rhijn, Bas W. G. and Mertens, Laura S. (2023) Added Clinical Value of 18F-FDG-PET/CT to Stage Patients With High-Risk Non-Muscle Invasive Bladder Cancer Before Radical Cystectomy. CLINICAL GENITOURINARY CANCER, 21 (3). pp. 342-348. ISSN 1558-7673, 1938-0682
Full text not available from this repository. (Request a copy)Abstract
The value of 18F-fluorodeoxyglucose positron-emission-tomography-computed tomography (FDG-PET/CT) for staging patients with (very) high-risk non-muscle invasive bladder cancer (NMIBC) is unknown. In this study among NMIBC patients referred for RC, FDG-PET/CT detected metastases that were not detected by CT, leading to treatment changes in 10% of patients. However, the use of FDG-PET/CT should be weighed against its disad-vantages, including false-positive lesions. Introduction and Objectives: 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET/CT) is increasingly used in the preoperative staging of patients with muscle-invasive bladder cancer. The clinical added value of FDG-PET/CT in high-risk non-muscle invasive bladder cancer (NMIBC) is unknown. In this study, the value of FDG-PET/CT in addition to contrast enhanced (CE)-CT was evaluated in high-risk NMIBC before radical cystec-tomy (RC). Materials and Methods: This is a retrospective analysis of consecutive patients with high risk and very-high risk urothelial NMIBC scheduled for RC in a tertiary referral center between 2011 and 2020. Patients underwent staging with CE-CT (chest and abdomen/pelvis) and FDG-PET/CT. We assessed the clinical disease stage before and after FDG-PET/CT and the treatment recommendation based on the stage before and after FDG-PET/CT. The accuracy of CT and FDG-PET/CT for identifying metastatic disease was defined by the receiver-operating curve using a reference -standard including histopathology/cytology (if available), imaging and follow-up. Results: A total of 92 patients were identified (median age: 71 years). In 14/92 (15%) patients, FDG-PET/CT detected metastasis (12 suspicious lymph nodes and 4 distant metastases). The disease stage changed in 11/92 (12%) patients based on additional FDG-PET/CT findings. FDG-PET/CT led to a different treatment in 9/92 (10%) patients. According to the reference standard, 25/92 (27%) patients had metastases. The sensitivit y, specificit y and accuracy of FDG-PET/CT was 36%, 93% and 77% respectively, versus 12%, 97% and 74% of CE-CT only. The area under the ROC curve was 0.643 for FDG-PET/CT and 0.545 for CT, P = .036. Conclusion: The addition of FDG-PET/CT to CE-CT imaging changed the treatment in 10% of patients and proved to be a valuable diagnostic tool in a selected subgroup of NMIBC patients scheduled for RC.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY; COMPUTED-TOMOGRAPHY; PET/CT; MANAGEMENT; Positron-emission tomography-computed tomography; Diagnosis; Imaging; Accuracy; Treatment change; Non-muscle invasive bladder cancer |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Mar 2024 12:41 |
| Last Modified: | 23 Mar 2024 12:41 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60461 |
Actions (login required)
 |
View Item |
