OBJECTIVE:The purpose of this study was to prospectively investigate the value of a standardized F-fluorodeoxyglucose (F-FDG)-PET/computed tomography (CT) protocol for imaging of primary bladder cancer, using standardized bladder flushing and filling.
METHODS:We included 19 patients with cT1-4 bladder cancer. A Foley catheter was inserted before F-FDG injection. PET/CT imaging was performed according to four bladder protocols: (1) bladder empty; (2) bladder empty after flushing; (3) bladder filled with 50 ml saline; and (4) bladder filled with 100 ml saline. Tumour visibility was assessed and compared with histopathology or CT and cystoscopy.
RESULTS:The procedure was successfully completed in 16 out of 19 patients. The reference standard revealed a bladder tumour in 16 out of 19 patients. Sensitivity of protocols 1 and 2 was 0.38 [95% confidence interval (CI), 0.16-0.64] compared with 0.63 (95% CI, 0.36-0.84) for protocols 3 and 4.
CONCLUSION: Flushing and subsequent retrograde filling of the bladder results in the highest rate of tumour visualization and quantification. Flushing alone is inferior.
Written by:
Mertens LS, Bruin NM, Vegt E, de Blok WM, Fioole-Bruining A, van Rhijn BW, Horenblas S, Vogel WV. Are you the author?
Departments of Urology, Nuclear Medicine, Radiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Reference: Nucl Med Commun. 2012 Jul 6. Epub ahead of print.
doi: 10.1097/MNM.0b013e3283567473
PubMed Abstract
PMID: 22781846
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