The treatment and prognosis of bladder cancer are based on the depth of primary tumour invasion and the presence of metastases.
A highly accurate preoperative tumour, node, metastasis (TNM) staging is critical to proper patient management and treatment. This study retrospectively investigated the value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed axial tomography ((18)F-FDG PET/CT) and magnetic resonance imaging (MRI) for preoperative N staging of bladder cancer.
From June 2006 to January 2008, 48 consecutive patients diagnosed with bladder cancer were referred to preoperative staging including MRI and (18)F-FDG PET/CT. Eighteen out of 48 patients underwent radical cystoprostatectomy including removal of lymph nodes for histology, and were included in the study. Values of (18)F-FDG PET/CT and MRI for regional N staging were compared to histopathology findings, the gold standard.
(18)F-FDG PET/CT and MRI were performed in 18 patients. The specificities for detection of lymph-node metastases for MRI and (18)F-FDG PET/CT were 80% (n = 15) and 93.33% (n = 15), respectively. The negative predictive values were 80% (n = 15) and 87.5% (n = 16) for MRI and (18)F-FDG PET/CT, respectively. The differences in specificity and negative predictive values were not statistically significant.
No significant statistical difference between (18)F-FDG PET/CT and MRI for preoperative N staging of urothelial bladder cancer was found in the study. However, the trend of the data indicates an advantage of (18)F-FDG PET/CT over MRI. Larger prospective studies are needed to elucidate the role of (18)F-FDG PET/CT in N staging of bladder cancer.
Written by:
Jensen TK, Holt P, Gerke O, Riehmann M, Svolgaard B, Marcussen N, Bouchelouche K.
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Reference: Scand J Urol Nephrol. 2011 Jan 13. Epub ahead of print.
doi: 10.3109/00365599.2010.544672
PubMed Abstract
PMID: 21231796
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