You have accessJournal of UrologyBladder Cancer: Invasive (I)1 Apr 20131434 THE STAGING ROLE OF 18FDG PET-CT IN PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER SELECTED FOR RADICAL CYSTECTOMY Mariaconsiglia Ferriero, Giuseppe Simone, Rocco Papalia, Salvatore Guaglianone, Rosa Sciuto, Carlo Ludovico Maini, and Michele Gallucci Mariaconsiglia FerrieroMariaconsiglia Ferriero Rome, Italy More articles by this author , Giuseppe SimoneGiuseppe Simone Rome, Italy More articles by this author , Rocco PapaliaRocco Papalia Rome, Italy More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone Rome, Italy More articles by this author , Rosa SciutoRosa Sciuto Rome, Italy More articles by this author , Carlo Ludovico MainiCarlo Ludovico Maini Rome, Italy More articles by this author , and Michele GallucciMichele Gallucci Rome, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2788AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preoperative staging of patients with muscle invasive bladder cancer includes either CT scan or MR imaging. Few reports addressed the staging role of 18FDG PET-CT and its role has not been defined. METHODS Between July 2009 and Feb 2012, 76 consecutive patients with muscle-invasive bladder cancer and conventional imaging negative for nodal or distant metastasis, underwent 18FDG PET-CT before radical cystectomy. Nine patients with evidence of liver, bone or retroperitoneal metastases at PET-CT underwent palliative cystectomy, all other patients underwent radical cystectomy and extended lymph-node dissection 2cm over the aortic bifurcation. Nodes were sent to pathologist into separate packages. We tested sensitivity, specificity, PPV, NPV and accuracy of 18FDG PET-CT alone in a patient and in a field-based manner, matching results with pathological examinations of nodal packages removed. RESULTS Lymph node metastasis were found in 24 of 76 patients (31%). Eighty-six of 758 dissected nodal fields showed metastasis (11.3%). Positive sites detected by 18FDG PET-CT were confirmed by histology in 45 cases and were not in 10 cases, while 662 sites were true negative versus 41 false negative (cases of nodal micrometastasis or with size of metastasis < 5 mm). On patient based analysis, sensitivity, specificity, PPV, NPV and accuracy were 56.6%, 95.6%, 89.5%, 77.2% and 80.2% respectively and on field-based analysis the calculated percentages were 52.3%, 98.5%, 81.8%, 94.2% and 93.3% respectively. CONCLUSIONS Despite low sensitivity 18FDG PET/CT detected nodal metastases between 5 and 10 mm and represents a step forward in the preoperative staging compared with conventional CT. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e587 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mariaconsiglia Ferriero Rome, Italy More articles by this author Giuseppe Simone Rome, Italy More articles by this author Rocco Papalia Rome, Italy More articles by this author Salvatore Guaglianone Rome, Italy More articles by this author Rosa Sciuto Rome, Italy More articles by this author Carlo Ludovico Maini Rome, Italy More articles by this author Michele Gallucci Rome, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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