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21.01.2019 | Nuclear Medicine

Integrated analysis of ¹⁸F-FDG PET/CT improves preoperative lymph node staging for patients with invasive bladder cancer

verfasst von: Antoine Girard, Mathieu Rouanne, Sarah Taconet, Camélia Radulescu, Yann Neuzillet, Astrid Girma, Aurélie Beaufrere, Thierry Lebret, Elise Le Stanc, Jean-François Grellier

Erschienen in: European Radiology | Ausgabe 8/2019

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Abstract

Objectives

Preoperative ¹⁸F-fluoro-2-deoxy-d-glucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) is controversial to assess lymph node (LN) staging in patients with invasive bladder cancer. We proposed to use the maximum standardized uptake value (SUV_max) associated with axial-based LN size to improve the detection of regional LN metastasis.

Methods

From May 2015 to May 2017, we prospectively included patients with urothelial bladder cancer who underwent radical cystectomy with extended pelvic LN dissection. All patients underwent preoperative ¹⁸F-FDG PET/CT staging before surgery. The gold standard comparator was the pathological examination of resected LNs. The data were reported on a regional per area- and patient-based model according to SUV_max values and axial-based LN size criteria.

Results

In total, 1012 LNs were identified in 61 patients with clinically localized invasive bladder cancer who underwent radical cystectomy and extended pelvic LN dissection. Loco-regional involvement of 24 LN areas was confirmed in 17 patients. In per area analysis, diagnostic accuracy of PET/CT and CT alone were respectively 84% and 78% (p = 0.039). On patient-based analysis, combined PET/CT correctly classified pelvic LN status in 5/61 (+ 8%) additional patients using optimal thresholds compared to CT alone, with accuracies of 82% and 74%, respectively (p = 0.13).

Conclusion

Combining SUV_max and axial-based LN size criteria using ¹⁸F-FDG PET/CT improved the diagnostic accuracy for preoperative LN staging in patients with invasive bladder cancer, in per area analysis.

Key Points

• Combining metabolical and morphological features using¹⁸F-FDG PET/CT improves the detection of malignant lymph node in patients with bladder cancer.

• ¹⁸ F-FDG PET/CT may help for initial staging of patients with muscle invasive bladder cancer.

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Titel: Integrated analysis of 18F-FDG PET/CT improves preoperative lymph node staging for patients with invasive bladder cancer
verfasst von: Antoine Girard
Mathieu Rouanne
Sarah Taconet
Camélia Radulescu
Yann Neuzillet
Astrid Girma
Aurélie Beaufrere
Thierry Lebret
Elise Le Stanc
Jean-François Grellier
Publikationsdatum: 21.01.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5959-0

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Integrated analysis of ¹⁸F-FDG PET/CT improves preoperative lymph node staging for patients with invasive bladder cancer

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Objectives

Methods

Results

Conclusion

Key Points

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