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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

PET/CT versus conventional CT for detection of lymph node metastases in patients with locally advanced bladder cancer

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Firas Aljabery, Gunnar Lindblom, Susann Skoog, Ivan Shabo, Hans Olsson, Johan Rosell, Staffan Jahnson
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

FJ: Designed the study. Analysis and interpretations of the data. Revising and drafting the manuscript. GL: Participated in designing the study. Carried out the radiological study. SS: Participated in designing the study. Carried out the radiological study. JR: Carried out the statistical analysis. IS: Participated in designing the study. Analysis and interpretations of the data. Revising and drafting the manuscript. HO: Participated in designing the study. Carried out the histopathological analysis. SJ: Designed the study. Analysis and interpretations of the data. Revising and drafting the manuscript. All authors read and approved the final manuscript.

Abstract

Background

We studied patients treated with radical cystectomy for locally advanced bladder cancer to compare the results of both preoperative positron emission tomography/computed tomography (PET/CT) and conventional CT with the findings of postoperative histopathological evaluation of lymph nodes.

Methods

Patients who had bladder cancer and were candidates for cystectomy underwent preoperative PET/CT using 18-fluorodeoxyglucose (FDG) and conventional CT. The results regarding lymph node involvement were independently evaluated by two experienced radiologists and were subsequently compared with histopathology results, the latter of which were reassessed by an experienced uropathologist (HO).

Results

There were 54 evaluable patients (mean age 68 years, 47 [85 %] males and 7 [15 %] females) with pT and pN status as follows: < pT2-14 (26 %), pT2-10 (18 %), and > pT2-30 (56 %); pN0 37 (69 %) and pN+ 17 (31 %). PET/CT showed positive lymph nodes in 12 patients (22 %), and 7 of those cases were confirmed by histopathology; the corresponding results for conventional CT were 11 (20 %) and 7 patients (13 %), respectively. PET/CT had 41 % sensitivity, 86 % specificity, 58 % PPV, and 76 % NPV, whereas the corresponding figures for conventional CT were 41 %, 89 %, 64 %, and 77 %. Additional analyses of the right and left side of the body or in specified anatomical regions gave similar results.

Conclusions

In this study, PET/CT and conventional CT had similar low sensitivity in detecting and localizing regional lymph node metastasis in bladder cancer.
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