The Usefulness of Positron Emission Tomography/Computed Tomography in the Diagnosis of Metastasis in Patients with Urothelial Carcinoma — A Secondary Publication
Download PDF
$currentUrl="http://$_SERVER[HTTP_HOST]$_SERVER[REQUEST_URI]"

Keywords

Urothelial cancer
PET/CT
Diagnosis

DOI

10.26689/ur.v2i1.6504

Submitted : 2024-04-16
Accepted : 2024-05-01
Published : 2024-05-16

Abstract

Purpose: This study examined the usefulness of positron emission tomography (PET)/computed tomography (CT) in the diagnosis of metastasis in patients with urothelial carcinoma. Materials and methods: The subjects were patients who were newly diagnosed with urothelial carcinoma in our department on whom we performed CT and PET/CT to search for metastasis. Results: The median age of the 92 subjects was 71 years, and bladder and upper tract urothelial cancer were underlying diseases in 41 (46%) and 51 (54%) patients, respectively. In 66 (72%) of the 92 cases, no metastasis was observed by CT, while PET/CT revealed metastasis in 9 (14%). The 57 (86%) patients in whom both CT and PET/CT showed no metastasis underwent radical surgery, while 2 patients (4%) exhibited pathological lymph node metastasis. Of the 26 patients in whom CT revealed metastasis, PET/CT showed no metastasis in 3 (12%), and the absence of pathological metastasis was confirmed in all patients. Of the 23 patients found to have metastasis in both CT and PET/CT, metastasis that could not be identified by CT was discovered by performing PET/CT in 10 (43%) patients. PET/CT showed significantly higher diagnostic accuracy than CT alone (P < 0.01), with sensitivities of 94.1% and 67.6%, specificities of 100% and 94.8%, and accuracy rates of 97.8% and 84.7%, respectively. Conclusions: PET/CT of patients with urothelial cancer revealed that metastases that cannot be diagnosed by CT alone are found at a significant frequency. Since these metastases can affect treatment choices in patients with urothelial cancer, PET/CT is considered to be useful in diagnosing metastases in patients with urothelial cancer.

References

Stein JP, Lieskovsky G, Cote R, et al., 2001, Radical Cystectomy in the Treatment of Invasive Bladder Cancer: Long-Term Results in 1,054 Patients. J Clin Oncol, 2001(19): 666–675.

Margulis V, Shariat SF, Matin SF, et al., 2009, The Upper Tract Urothelial Carcinoma C: Outcomes of Radical Nephroureterectomy: A Series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer, 2009(115): 1224–1233.

Hirobe M, Tanaka T, Shindo T, et al., 2018, Complications Within 90 Days After Radical Cystectomy for Bladder Cancer: Results of a Multicenter Prospective Study in Japan. Int J Clin Oncol, 2018(23): 734–741.

Goodfellow H, Viney Z, Hughes P, et al., 2014, Role of Fluorodeoxyglucose Positron Emission Tomography (FDG PET) -Computed Tomography (CT) in the Staging of Bladder Cancer. BJU Int, 2014(114): 389–395.

Swinnen G, Maes A, Pottel H, et al., 2010, FDG-PET/CT for the Preoperative Lymph Node Staging of Invasive Bladder Cancer. Eur Urol, 2010(57): 641–647.

Vind-Kezunovic S, Bouchelouche K, Ipsen P, et al., 2019, Detection of Lymph Node Metastasis in Patients with Bladder Cancer Using Maximum Standardised Uptake Value and (18)F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Results from a High-Volume Centre Including Long-Term Follow-Up. Eur Urol Focus, 2019(5): 90–96.

Minamoto R, Tateishi T, Inoue T, 2010, Uroepithelial Carcinoma and PET Surgery. Clinical Urology, 2010(64): 1009–1015.

Mertens LS, Fioole-Bruining A, Vegt E, et al., 2013, Impact of (18)F-Fluorodeoxyglucose (FDG) -Positron-Emission Tomography/Computed Tomography (PET/CT) on Management of Patients with Carcinoma Invading Bladder Muscle. BJU Int, 2013(112): 729–734.

Kanda Y, 2012, Investigation of the Freely Available Easy-to-Use Software ?EZR? for Medical Statistics. Bone Marrow Transplantation, 2012(48): 452–458.

Scolieri MJ, Paik ML, Brown SL, et al., 2000, Limitations of Computed Tomography in the Preoperative Staging of Upper Tract Urothelial Carcinoma. Urology, 2000(56): 930–934.

Tanaka H, Yoshida S, Komai Y, et al., 2016, Clinical Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Upper Tract Urothelial Carcinoma: Impact on Detection of Metastases and Patient Management. Urol Int, 2016(96): 65–72.

Girard A, Rouanne M, Taconet S, et al., 2019, Integrated Analysis of (18)F-FDG PET/CT Improves Preoperative Lymph Node Staging for Patients with Invasive Bladder Cancer. Eur Radiol, 2019(29): 4286–4293.