Comparing fluorodeoxyglucose positron emission tomography with computed tomography in staging for nodal and distant metastasis in urothelial/bladder cancer

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Main Authors: Mohammed Al‐Zubaidi, Katherine Ong, Pravin Viswambaram, Haider Bangash, Glenn Boardman, Steve P. McCombie, Oliver Oey, Nicole Swarbrick, Andrew Redfern, Jeremy Ong, Richard Gauci, Ronny Low, Dickon Hayne
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Published: Wiley 2024
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author Mohammed Al‐Zubaidi
Katherine Ong
Pravin Viswambaram
Haider Bangash
Glenn Boardman
Steve P. McCombie
Oliver Oey
Nicole Swarbrick
Andrew Redfern
Jeremy Ong
Richard Gauci
Ronny Low
Dickon Hayne
author_facet Mohammed Al‐Zubaidi
Katherine Ong
Pravin Viswambaram
Haider Bangash
Glenn Boardman
Steve P. McCombie
Oliver Oey
Nicole Swarbrick
Andrew Redfern
Jeremy Ong
Richard Gauci
Ronny Low
Dickon Hayne
Mohammed Al‐Zubaidi
Katherine Ong
Pravin Viswambaram
Haider Bangash
Glenn Boardman
Steve P. McCombie
Oliver Oey
Nicole Swarbrick
Andrew Redfern
Jeremy Ong
Richard Gauci
Ronny Low
Dickon Hayne
collection Wiley Open Access
contents Comparing fluorodeoxyglucose positron emission tomography with computed tomography in staging for nodal and distant metastasis in urothelial/bladder cancer Mohammed Al‐Zubaidi Katherine Ong Pravin Viswambaram Haider Bangash Glenn Boardman Steve P. McCombie Oliver Oey Nicole Swarbrick Andrew Redfern Jeremy Ong Richard Gauci Ronny Low Dickon Hayne BJUI Compass AbstractObjectivesWe aim to assess the clinical value of 18F‐fluorodeoxyglucose positron (18F‐FDG‐PET) scan in detecting nodal and distant metastasis compared with computed tomography (CT) scan in patients with urothelial carcinoma or bladder cancer, aiming to improve staging accuracy and thereby better prognosticate and determine therapy.MethodsA retrospective review of 75 patients with invasive bladder cancer (≥T1) who were staged with both CT and 18F‐FDG‐PET within an 8‐week interval was performed for the period between 2015 and 2020. Seventy‐two per cent (54/75) had formal pelvic lymph node (LN) dissection or biopsy of lesions suspicious for metastases. FDG‐PET definitions for positive sites were assessed depending on SUV Max (nodes with SUVmax >4 at any size, SUV > 2 for lymph nodes >8 mm, or any SUV if the lymph node was >10 mm on axial images). For CT scanning, enlarged LN by RECIST 1.1 criteria (>10 mm) as well as qualitative findings suggesting metastasis were considered positive. The analysis was based on the comparison of CT and 18F‐FDG‐PET findings to histopathology results from LN dissection or biopsies.ResultsSensitivity, specificity, positive predictive values (PPV) and negative predictive value (NPV) of CT versus FDG‐PET for detecting metastasis, in patients who underwent pelvic LN dissection or biopsy of lesions suspicious of metastases, were 46.6% (95% CI: 21%–70%) versus 60% (95% CI: 32%–84%), 100% (95% CI: 91%–100%) versus 83.78% (95% CI: 69%–94%), 100% (95% CI: 63%–100%) versus 60% (95% CI: 32%–84%), and 82.2% (95% CI: 68%–92%) versus 83.78% (95% CI: 69%–94%), respectively. 7/75 (9.3%) patients avoided cystectomy due to 18F‐FDG‐PET features of metastases that were not detected by CT.ConclusionFDG‐PET may be more sensitive than CT for metastases in the staging of bladder cancer, which resulted in significant avoidance of aggressive local management in cases with occult metastasis. 10.1002/bco2.304 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/bco2.304
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institution Wiley Open Access
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publishDate 2024
publisher Wiley
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spellingShingle Comparing fluorodeoxyglucose positron emission tomography with computed tomography in staging for nodal and distant metastasis in urothelial/bladder cancer
Mohammed Al‐Zubaidi
Katherine Ong
Pravin Viswambaram
Haider Bangash
Glenn Boardman
Steve P. McCombie
Oliver Oey
Nicole Swarbrick
Andrew Redfern
Jeremy Ong
Richard Gauci
Ronny Low
Dickon Hayne
BJUI Compass
Comparing fluorodeoxyglucose positron emission tomography with computed tomography in staging for nodal and distant metastasis in urothelial/bladder cancer Mohammed Al‐Zubaidi Katherine Ong Pravin Viswambaram Haider Bangash Glenn Boardman Steve P. McCombie Oliver Oey Nicole Swarbrick Andrew Redfern Jeremy Ong Richard Gauci Ronny Low Dickon Hayne BJUI Compass AbstractObjectivesWe aim to assess the clinical value of 18F‐fluorodeoxyglucose positron (18F‐FDG‐PET) scan in detecting nodal and distant metastasis compared with computed tomography (CT) scan in patients with urothelial carcinoma or bladder cancer, aiming to improve staging accuracy and thereby better prognosticate and determine therapy.MethodsA retrospective review of 75 patients with invasive bladder cancer (≥T1) who were staged with both CT and 18F‐FDG‐PET within an 8‐week interval was performed for the period between 2015 and 2020. Seventy‐two per cent (54/75) had formal pelvic lymph node (LN) dissection or biopsy of lesions suspicious for metastases. FDG‐PET definitions for positive sites were assessed depending on SUV Max (nodes with SUVmax >4 at any size, SUV > 2 for lymph nodes >8 mm, or any SUV if the lymph node was >10 mm on axial images). For CT scanning, enlarged LN by RECIST 1.1 criteria (>10 mm) as well as qualitative findings suggesting metastasis were considered positive. The analysis was based on the comparison of CT and 18F‐FDG‐PET findings to histopathology results from LN dissection or biopsies.ResultsSensitivity, specificity, positive predictive values (PPV) and negative predictive value (NPV) of CT versus FDG‐PET for detecting metastasis, in patients who underwent pelvic LN dissection or biopsy of lesions suspicious of metastases, were 46.6% (95% CI: 21%–70%) versus 60% (95% CI: 32%–84%), 100% (95% CI: 91%–100%) versus 83.78% (95% CI: 69%–94%), 100% (95% CI: 63%–100%) versus 60% (95% CI: 32%–84%), and 82.2% (95% CI: 68%–92%) versus 83.78% (95% CI: 69%–94%), respectively. 7/75 (9.3%) patients avoided cystectomy due to 18F‐FDG‐PET features of metastases that were not detected by CT.ConclusionFDG‐PET may be more sensitive than CT for metastases in the staging of bladder cancer, which resulted in significant avoidance of aggressive local management in cases with occult metastasis. 10.1002/bco2.304 http://creativecommons.org/licenses/by/4.0/
title Comparing fluorodeoxyglucose positron emission tomography with computed tomography in staging for nodal and distant metastasis in urothelial/bladder cancer
topic BJUI Compass
url https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.304