The impact of 18F-fluorodeoxyglucose PET/computed tomography on clinical staging in bladder cancer. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Coskun, Nazim; Cagdas, Berkay; Eroglu, Unsal; Aslan, Yilmaz; Turkolmez, Seyda
• Is Part Of: Nuclear medicine communications. Volume 43:Issue 2(2022)
• Publication Date: 2022-02
• Subjects: bladder cancer -- computed tomography -- MRI -- PET; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000001509
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Aim: To determine the impact of 18 F-FDG PET/computed tomography (CT) on clinical staging in bladder cancer with comparison to conventional CT and MRI. Methods: A total of 142 patients who underwent 18 F-FDG PET/CT imaging with a diagnosis of bladder cancer between 1 June 2019 and 31 December 2020 were screened retrospectively. Seventy patients who underwent diagnostic CT or MRI within 2 months before or after PET/CT were included in the study. The N and M stages determined by CT, MRI and PET/CT according to the eighth version of the TNM staging system were recorded. T-test was used to determine the levels of significant difference, and univariate logistic regression analysis was used to evaluate the impact of the T stage on nodal up-staging. Results: According to the PET/CT, the N stage increased in 19 patients (27.14%) and decreased in seven patients (10%). Likewise, the M stage increased in 16 patients (22.86%) and decreased in seven patients (10%). The N stage determined by PET/CT was confirmed by pathologic examination in all cases in which the two modalities were inconsistent. In muscle-invasive cases, the rate of increase in the N stage after PET/CT (36.95%) was found to be significantly higher than in that of cases without invasion (8.33%) ( P = 0.011). Increasing T stage was associated with an increase in the N stage after PET/CT (odds ratio: 2.33, 95% confidence interval: 1.02–5.28, P = 0.042). Conclusion: 18 F-FDG PET/CT can potentially change the clinical stage determined by CT and MRI when used for staging in bladder cancer, and can lead to nodal up-staging particularly in cases with muscle-invasive bladder cancer.