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[F-18]Fluorodeoxyglucose - positron emission tomography/computed tomography improves staging in patients with high-risk muscle-invasive bladder cancer scheduled for radical cystectomy

Kollberg, Petter LU ; Almquist, Helén LU ; Bläckberg, Mats LU ; Cronberg, Carin LU ; Garpered, Sabine LU ; Gudjonsson, Sigurdur LU ; Kleist, Jakob ; Lyttkens, Kerstin LU ; Hultman Patschan, Oliver LU and Liedberg, Fredrik LU (2015) In Scandinavian Journal of Urology 49(4). p.296-301
Abstract
Objective. The aim of this study was to evaluate the clinical use of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in addition to conventional preoperative radiological investigations in a defined group of patients with high-risk muscle-invasive bladder cancer. Materials and methods. In total, 103 patients with high-risk muscle-invasive bladder cancer defined as stage T3/T4 disease or as stage T2 with hydronephrosis or high-risk histological features, who were provisionally scheduled to undergo cystectomy, were prospectively recruited to the study. The patients were referred to FDG-PET/CT in addition to standard preoperative investigation with computed tomography (CT). The final treatment decision... (More)
Objective. The aim of this study was to evaluate the clinical use of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in addition to conventional preoperative radiological investigations in a defined group of patients with high-risk muscle-invasive bladder cancer. Materials and methods. In total, 103 patients with high-risk muscle-invasive bladder cancer defined as stage T3/T4 disease or as stage T2 with hydronephrosis or high-risk histological features, who were provisionally scheduled to undergo cystectomy, were prospectively recruited to the study. The patients were referred to FDG-PET/CT in addition to standard preoperative investigation with computed tomography (CT). The final treatment decision was reached at a multidisciplinary conference based on all available information including the FDG-PET/Cf findings. Results. Compared to CT alone, FDG-PET/CT provided more supplemental findings suggesting malignant manifestations in 48 (47%) of the 103 patients. The additional FDG-PET/CT findings led to an altered provisional treatment plan in 28 out of 103 patients (27%), detection of disseminated bladder cancer and subsequent cancellation of the initially intended cystectomy in 16 patients, and identification of disseminated disease and treatment with induction chemotherapy before radical cystectomy in 12 patients. Conclusions. Preoperative FDG-PET/CT changed the treatment plan for a considerable proportion (27%) of the present patients. Accordingly, such examination can potentially improve the preoperative staging of cystectomy patients with high-risk features, and may also reduce the number of futile operations in patients with advanced disease who are beyond cure. (Less)
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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder cancer, computed tomography, positron emission tomography, radical cystectomy
in
Scandinavian Journal of Urology
volume
49
issue
4
pages
296 - 301
publisher
Taylor & Francis
external identifiers
  • wos:000359170200005
  • scopus:84937569964
  • pmid:25623843
ISSN
2168-1813
DOI
10.3109/21681805.2014.990053
language
English
LU publication?
yes
id
bc48d216-320d-4090-b600-a8b87ab89dcc (old id 7979246)
date added to LUP
2016-04-01 10:29:52
date last changed
2023-08-31 04:27:57
@article{bc48d216-320d-4090-b600-a8b87ab89dcc,
  abstract     = {{Objective. The aim of this study was to evaluate the clinical use of [F-18]-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in addition to conventional preoperative radiological investigations in a defined group of patients with high-risk muscle-invasive bladder cancer. Materials and methods. In total, 103 patients with high-risk muscle-invasive bladder cancer defined as stage T3/T4 disease or as stage T2 with hydronephrosis or high-risk histological features, who were provisionally scheduled to undergo cystectomy, were prospectively recruited to the study. The patients were referred to FDG-PET/CT in addition to standard preoperative investigation with computed tomography (CT). The final treatment decision was reached at a multidisciplinary conference based on all available information including the FDG-PET/Cf findings. Results. Compared to CT alone, FDG-PET/CT provided more supplemental findings suggesting malignant manifestations in 48 (47%) of the 103 patients. The additional FDG-PET/CT findings led to an altered provisional treatment plan in 28 out of 103 patients (27%), detection of disseminated bladder cancer and subsequent cancellation of the initially intended cystectomy in 16 patients, and identification of disseminated disease and treatment with induction chemotherapy before radical cystectomy in 12 patients. Conclusions. Preoperative FDG-PET/CT changed the treatment plan for a considerable proportion (27%) of the present patients. Accordingly, such examination can potentially improve the preoperative staging of cystectomy patients with high-risk features, and may also reduce the number of futile operations in patients with advanced disease who are beyond cure.}},
  author       = {{Kollberg, Petter and Almquist, Helén and Bläckberg, Mats and Cronberg, Carin and Garpered, Sabine and Gudjonsson, Sigurdur and Kleist, Jakob and Lyttkens, Kerstin and Hultman Patschan, Oliver and Liedberg, Fredrik}},
  issn         = {{2168-1813}},
  keywords     = {{Bladder cancer; computed tomography; positron emission tomography; radical cystectomy}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{296--301}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{[F-18]Fluorodeoxyglucose - positron emission tomography/computed tomography improves staging in patients with high-risk muscle-invasive bladder cancer scheduled for radical cystectomy}},
  url          = {{http://dx.doi.org/10.3109/21681805.2014.990053}},
  doi          = {{10.3109/21681805.2014.990053}},
  volume       = {{49}},
  year         = {{2015}},
}