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18 F ‐fluorodeoxyglucose positron emission tomography–computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: A prospective study
Author(s) -
HitierBerthault Maryam,
Ansquer Catherine,
Branchereau Julien,
Renaudin Karine,
Bodere Françoise,
Bouchot Olivier,
Rigaud Jérôme
Publication year - 2013
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12045
Subject(s) - medicine , cystectomy , positron emission tomography , bladder cancer , lymph node , radiology , fluorodeoxyglucose , nuclear medicine , dissection (medical) , tomography , cancer , pathology
Objectives The objective of our study was to analyze the diagnostic performance of 18 F‐fluorodeoxyglucose positron emission tomography–computed tomography for lymph node staging in patients with bladder cancer before radical cystectomy and to compare it with that of computed tomography. Methods A total of 52 patients operated on between 2005 and 2010 were prospectively included in this prospective, mono‐institutional, open, non‐randomized pilot study. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. 18 F‐fluorodeoxyglucose positron emission tomography–computed tomography in addition to computed tomography was carried out for lymph node staging of bladder cancer before radical cystectomy. Lymph node dissection during radical cystectomy was carried out. Findings from 18 F‐fluorodeoxyglucose positron emission tomography–computed tomography and computed tomography were compared with the results of definitive histological examination of the lymph node dissection. The diagnostic performance of the two imaging modalities was assessed and compared. Results The mean number of lymph nodes removed during lymph node dissection was 16.5 ± 10.9. Lymph node metastasis was confirmed on histological examination in 22 cases (42.3%). This had been suspected in five cases (9.6%) on computed tomography and in 12 cases (23.1%) on 18 F‐fluorodeoxyglucose positron emission tomography–computed tomography. Sensitivity, specificity, positive predictive value, negative predictive value, relative risk and accuracy were 9.1%, 90%, 40%, 57.4%, 0.91 and 55.7%, respectively, for computed tomography, and 36.4%, 86.7%, 66.7%, 65%, 2.72, 65.4%, respectively, for 18 F‐fluorodeoxyglucose positron emission tomography–computed tomography. Conclusions 18 F‐fluorodeoxyglucose positron emission tomography–computed tomography is more reliable than computed tomography for preoperative lymph node staging in patients with invasive bladder carcinoma undergoing radical cystectomy.