z-logo
Premium
Impact of 18 F ‐fluorodeoxyglucose ( FDG )‐positron‐emission tomography/computed tomography ( PET / CT ) on management of patients with carcinoma invading bladder muscle
Author(s) -
Mertens Laura S.,
FiooleBruining Annemarie,
Vegt Erik,
Vogel Wouter V.,
Rhijn Bas W.,
Horenblas Simon
Publication year - 2013
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12109
Subject(s) - medicine , positron emission tomography , nuclear medicine , radiology , bladder cancer , fluorodeoxyglucose , pet ct , cancer
Objective To evaluate the clinical impact of 18 F ‐fluorodeoxyglucose ( FDG )‐positron‐emission tomography/computed tomography ( PET / CT ) scanning, compared with conventional staging with contrast‐enhanced CT imaging ( CECT ).Patients and Methods The FDG‐PET / CT results of 96 consecutive patients with bladder cancer were analysed. Patients included in this study underwent standard CECT imaging of the chest and abdomen/pelvis <4 weeks before FDG‐PET / CT . Based on the original imaging reports and recorded tumour stage before and after FDG‐PET / CT imaging, the preferred treatment strategies before FDG‐PET / CT and after FDG‐PET / CT were determined for each patient using an institutional multidisciplinary guideline. One of the following treatment strategies was chosen: (i) local curative treatment; (ii) neoadjuvant/induction chemotherapy; or (iii) palliation. The changes in management decisions before and after FDG‐PET / CT were assessed.Results The median (range) interval between CECT and FDG‐PET / CT was 0 (029) days. In 21.9% of the patients, stage on FDG‐PET / CT and CECT were different. Upstaging by FDG‐PET / CT was more frequent than downstaging (19.8 vs 2.1%). Clinical management changed for 13.5% of patients as a result of FDG‐PET / CT upstaging. In eight patients, FDG‐PET / CT detected second primary tumours. This led to changes of bladder cancer treatment in another four of 96 patients (4.2%). All the management changes were validated by tissue confirmation of the additional lesions.ConclusionsFDG‐PET / CT provides important additional staging information, which influences the treatment of carcinoma invading bladder muscle in almost 20% of cases. Patient selection for neoadjuvant/induction chemotherapy was improved and futile attempts at curative treatment in patients found to have metastases were avoided.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here