The role and effect of FDG-PET/CT on patient management and restaging of bladder carcinoma

Özet

Objective: To compare the diagnostic role of Florine-18 2-fluoro-2-deoxy-D-glucose-Positron emission tomography/computed tomography (FDG-PET/CT) in the restaging of bladder cancer with other radio - logical methods and to determine its effect on the treatment management of patients with bladder cancer. Material and methods: A total of 83 patients who showed suspicious lesions with radiologic methods and FDG-PET/CT images were enrolled in the study. Positive lesion sites were detected and compared in all imaging modalities. Positive lesions were confirmed by biopsy or serial radiological imaging. Fur - thermore, the rate of change of the management and treatment modalities of patients after FDG-PET/CT were noted. Results: The most frequent metastasis was observed in lymphatic localizations in all imaging methods. Lymph node metastases was detected with FDG-PET/CT in 37/83 patients, with computed tomography in 28/80 patients, and with magnetic resonance imaging in 6/19 patients. Lymph node metastasis was detected most commonly in the pelvic region with all modalities. Following lymphatic localization in FDG-PET/CT and CT, metastases were found most frequently in the lung and bone regions. FDG-PET/ CT also revealed 8 of the 12 local lesions that were detected by radiological methods and showed ad - ditional lesions in four patients that could not be demonstrated by radiological methods. FDG-PET/CT changed the treatment approaches in 34.9% (29/83) of patients. In 16 patients, it caused upstaging and commencement of advanced treatment methods. In 13 patients, malignancy was excluded in suspicious lesions and unnecessary advanced examination and treatment were avoided. FDG-PET/CT also caused three radical cystectomies, one partial cystectomy, and one urethrectomy in patients who had not under- gone any operational procedure previously. Conclusion: Despite physiological urinary tract uptake, FDG-PET/CT is superior to other imaging mo - dalities not only in distant localizations but also in evaluating pelvic lesions and lymph nodes. In addi - tion, the use of FDG-PET/CT during the restaging process contributes to the management of maximum number of patients