You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 2015PD4-07 PREOPERATIVE FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY ON THE DIAGNOSIS IN UPPER URINARY TRACT CANCER Seiji Asai, Toshio Kakuda, Kouji Hara, Terutaka Noda, Kenichi Nishimura, Tetsuya Fukumoto, Noriyoshi Miura, Yutaka Yanagihara, Akitomi Shirato, Yuki Miyauchi, Tadahiko Kikugawa, Masao Miyagawa, Nozomu Tanji, and Masayoshi Yokoyama Seiji AsaiSeiji Asai More articles by this author , Toshio KakudaToshio Kakuda More articles by this author , Kouji HaraKouji Hara More articles by this author , Terutaka NodaTerutaka Noda More articles by this author , Kenichi NishimuraKenichi Nishimura More articles by this author , Tetsuya FukumotoTetsuya Fukumoto More articles by this author , Noriyoshi MiuraNoriyoshi Miura More articles by this author , Yutaka YanagiharaYutaka Yanagihara More articles by this author , Akitomi ShiratoAkitomi Shirato More articles by this author , Yuki MiyauchiYuki Miyauchi More articles by this author , Tadahiko KikugawaTadahiko Kikugawa More articles by this author , Masao MiyagawaMasao Miyagawa More articles by this author , Nozomu TanjiNozomu Tanji More articles by this author , and Masayoshi YokoyamaMasayoshi Yokoyama More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.319AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Fluorodeoxygulcose positron emission tomography/computed tomography (FDG-PET/CT) is becoming useful for diagnosis, staging and prognosis in many cancers. In contrary, the use in urological oncology has been slower to develop because the radiotracer is excreted into the urine. Then, to assess the ability of preoperative FDG-PET/CT to detect upper urinary tract cancers (UUTC), compared with pathological examinations of tissues obtained by ureteroscopic biopsy or split cytologic analysis of urines obtained following retrograde pyelography. METHODS Clinicopathological records of patients who were examined by FDG-PET/CT were retrospectively reviewed. Sixty-four patients (66 lesions) with clinically suspected UUTC, who were diagnosed by ureteroscopy or nephroureterectomy or partial ureterectomy at our institution from September 2010 to September 2014, were included. The patient cohort consisted of 51 men and 13 women, with a median age of 73 (range 54–92) years. RESULTS 66 lesions were histologically diagnosed as 59 urothelial carcinomas and 1 clear cell carcinoma and 6 benign lesions. Only 22% of 58 lesions with UUTC had positive voided urine cytology and 45% of 47 lesions had positive split urine cytology. In addition, only 53 % of 15 lesions with UUTC had positive endoscopic biopsy. However, 83% of 60 lesions with UUTC had positive FDG-PET/CT examination. The positive predictive value was 93%. The sensitivities of <pT2 and ≥pT2 were 82% and 83%, respectively, and the sensitivities of G1, G2, and G3 tumors were 100%, 86%, and 82%, respectively. There were no correlations between the sensitivity in FDG-PET/CT and tumor stage or tumor grade. Mean SUVmax was 3.0 and 10.0 in benign lesions and UUTC, respectively. The difference was statistically significant (p=0.027). The ROC analysis showed that a SUVmax cut-off value to discriminate UUTC was 5.6. The sensitivity and the specificity were 76% and 80%, respectively. An area under the curve was 0.800 (Fig). CONCLUSIONS FDG-PET/CT was effective to detect UUTC. Furthermore, SUVmax had a role of supplementary index. FDG-PET/CT may be able to replace of endoscopic biopsy depending on the patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e89 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Seiji Asai More articles by this author Toshio Kakuda More articles by this author Kouji Hara More articles by this author Terutaka Noda More articles by this author Kenichi Nishimura More articles by this author Tetsuya Fukumoto More articles by this author Noriyoshi Miura More articles by this author Yutaka Yanagihara More articles by this author Akitomi Shirato More articles by this author Yuki Miyauchi More articles by this author Tadahiko Kikugawa More articles by this author Masao Miyagawa More articles by this author Nozomu Tanji More articles by this author Masayoshi Yokoyama More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...