Turkish Journal of Urology
UROONCOLOGY - Original Article
The role and effect of FDG-PET/CT on patient management and restaging of bladder carcinoma

The role and effect of FDG-PET/CT on patient management and restaging of bladder carcinoma


Department of Nuclear Medicine, Çukurova University School of Medicine, Adana, Turkey


Department of Urology, Çukurova University School of Medicine, Adana, Turkey

Turk J Urol 2019; 45: 423-430
DOI: 10.5152/tud.2019.84453
Read: 571 Downloads: 121 Published: 11 October 2019

Objective: To compare the diagnostic role of Florine-18 2-fluoro-2-deoxy-D-glucose-Positron emission tomography/computed tomography (FDG-PET/CT) in the restaging of bladder cancer with other radiological methods and to determine its effect on the treatment management of patients with bladder cancer.

Material and methods: A total of 83 patients who showed suspicious lesions with radiologic methods and FDG-PET/CT images were enrolled in the study. Positive lesion sites were detected and compared in all imaging modalities. Positive lesions were confirmed by biopsy or serial radiological imaging. Furthermore, the rate of change of the management and treatment modalities of patients after FDG-PET/CT were noted.

Results: The most frequent metastasis was observed in lymphatic localizations in all imaging methods. Lymph node metastases was detected with FDG-PET/CT in 37/83 patients, with computed tomography in 28/80 patients, and with magnetic resonance imaging in 6/19 patients. Lymph node metastasis was detected most commonly in the pelvic region with all modalities. Following lymphatic localization in FDG-PET/CT and CT, metastases were found most frequently in the lung and bone regions. FDG-PET/CT also revealed 8 of the 12 local lesions that were detected by radiological methods and showed additional lesions in four patients that could not be demonstrated by radiological methods. FDG-PET/CT changed the treatment approaches in 34.9% (29/83) of patients. In 16 patients, it caused upstaging and commencement of advanced treatment methods. In 13 patients, malignancy was excluded in suspicious lesions and unnecessary advanced examination and treatment were avoided. FDG-PET/CT also caused three radical cystectomies, one partial cystectomy, and one urethrectomy in patients who had not undergone any operational procedure previously.

Conclusion: Despite physiological urinary tract uptake, FDG-PET/CT is superior to other imaging modalities not only in distant localizations but also in evaluating pelvic lesions and lymph nodes. In addition, the use of FDG-PET/CT during the restaging process contributes to the management of maximum number of patients.


Cite this article as: Güney İB, Küçüker KA, İzol V, Kibar M. The role and effect of FDG-PET/CT on patient management and restaging of bladder carcinoma. Turk J Urol 2019; 45(6): 423-30.

ISSN2149-3235 EISSN 2149-3057