Clinical value of whole body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in the detection of metastatic bladder cancer

Int J Urol. 2012 Jul;19(7):639-44. doi: 10.1111/j.1442-2042.2012.02989.x. Epub 2012 Mar 27.

Abstract

Objectives: To investigate the value of whole-body fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for the detection of metastatic bladder cancer.

Methods: From December 2006 to August 2010, 60 bladder cancer patients (median age 60.5 years old, range 32-96) underwent whole body positron emission tomography/computed tomography positron emission tomography/computed tomography. The diagnostic accuracy was assessed by performing both organ-based and patient-based analyses. Identified lesions were further studied by biopsy or clinically followed for at least 6 months.

Results: One hundred and thirty-four suspicious lesions were identified. Among them, 4 primary cancers (2 pancreatic cancers, 1 colonic and 1 nasopharyngeal cancer) were incidentally detected, and the patients could be treated on time. For the remaining 130 lesions, positron emission tomography/computed tomography detected 118 true positive lesions (sensitivity = 95.9%). On the patient-based analysis, the overall sensitivity and specificity resulted to be 87.1% and 89.7%, respectively. There was no difference of sensitivity and specificity in patients with or without adjuvant treatment in terms of detection of metastatic sites by positron emission tomography/computed tomography. Compared with conventional imaging modality, positron emission tomography/computed tomography correctly changed the management in 15 patients (25.0%).

Conclusions: Positron emission tomography/computed tomography has excellent sensitivity and specificity in the detection of metastatic bladder cancer and it provides additional diagnostic information compared to standard imaging techniques.

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / diagnostic imaging*
  • Carcinoma / secondary*
  • Carcinoma, Small Cell / diagnostic imaging
  • Carcinoma, Small Cell / secondary
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Positron-Emission Tomography*
  • Radiographic Image Interpretation, Computer-Assisted
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*
  • Urinary Bladder Neoplasms / pathology*

Substances

  • Fluorodeoxyglucose F18