Detection of Lymph Node Metastasis in Patients with Bladder Cancer using Maximum Standardised Uptake Value and 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Results from a High-volume Centre Including Long-term Follow-up

Vind-Kezunovic, Stefan; Bouchelouche, Kirsten; Ipsen, Pia; Høyer, Søren; Bell, Cathrine; Jensen, Jørgen Bjerggaard

doi:10.1016/j.euf.2017.06.005

Cited by 47 publications

(36 citation statements)

References 15 publications

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“…Attempts to improve LN staging have shifted imaging towards increased use of MRI, which has a better soft tissue resolution (being able to detect LNM in normal sized LNs) than conventional CT (18). Routine use of F--fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT is still not recommended in bladder cancer staging or in LNM detection (18), however, its use is becoming more common due to recent reports suggesting that PET/CT and SU-Vmax interpretation is an appropriate tool in the evaluation of LN and can be used prior to surgery to make a safe identification of positive LNs (PET provides information on the potential malignancy of a LN through glucose metabolism by 18F-FDG uptake) (19).…”

Section: Discussionmentioning

confidence: 99%

Metastatic non-muscle invasive bladder cancer with cervical lymph node metastasis

et al. 2019

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A 72-year-old man with diabetes was admitted in January 2017 with complaints of lower urinary tract symptoms and microscopic hematuria. Review of the medical history showed that in 2012 he had undergone transurethral resection of a low-grade pTa bladder tumor (TURBT), without signs of recurrence until February 2017 when atypical urothelial cells were described by urine cytology and a small superfi cial bladder

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Section: Discussionmentioning

confidence: 99%

Metastatic non-muscle invasive bladder cancer with cervical lymph node metastasis

et al. 2019

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“…The recent rise of immune checkpoint inhibitors has also given additional weight to the accurate prediction of chemosensitivity, which could aid in treatment decisions for mUC patients . Supported by a growing body of evidence, the utility of FDG‐PET/CT in diagnosing metastases of UC is now widely acknowledged . On FDG‐PET/CT, UC metastases can be generally well distinguished based on the increased FDG uptake.…”

Section: Discussionmentioning

confidence: 99%

“…The present study focused on FDG uptake in metastases for predicting chemosensitivity and survival outcomes in mUC patients. FDG uptake was assessed by SUVmax, which is the most widely used parameter to quantitatively evaluate radioisotope uptake . The highest value among the SUVmax measurements obtained from all eligible lesions in each case (h‐SUVmax) was analyzed as an index representing a respective case, based on the hypothesis that the most aggressive lesion might define the patient's prognosis .…”

Section: Discussionmentioning

confidence: 99%

“…A growing body of evidence has shown the utility of FDG‐PET/CT in the diagnosis of metastases in UC patietns . Metastatic lesions of UC generally show increased FDG uptake; thus, they can be diagnosed more accurately on FDG‐PET/CT compared with conventional studies mainly based on CT . FDG uptake in metastases reflects the metabolic state of the lesions, and consequently could be associated with treatment sensitivity and/or patient prognosis, as has already been reported in several types of malignancies, such as malignant lymphoma and lung cancer .…”

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Impact of fluorodeoxyglucose uptake on positron emission tomography/computed tomography on chemosensitivity and survival in patients with metastatic urothelial carcinoma

et al. 2019

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Objectives: To evaluate the impact of fluorodeoxyglucose uptake on positron emission tomography/computed tomography on chemosensitivity and survival in patients with metastatic urothelial carcinoma. Methods: The present study assessed 51 metastatic urothelial carcinoma patients undergoing fluorodeoxyglucose positron emission tomography/computed tomography before first-line systemic chemotherapy. Fluorodeoxyglucose uptake in metastases was evaluated using the maximum standardized uptake value, which was measured for all eligible lesions, and the highest value among the maximum standardized uptake value measurements in each case was defined as the highest maximum standardized uptake value. The associations between the highest maximum standardized uptake value and objective response rate to chemotherapy, progression-free survival or cancer-specific survival were analyzed. For cancer-specific survival, the C-index was compared between multivariate models that incorporated predictors in the Bajorin model including the Karnofsky performance status and the presence of visceral metastasis, and the Apolo model additionally including hemoglobin and albumin levels, with/without the highest maximum standardized uptake value. Results: The median age was 69 years. The Karnofsky performance status was ≥80% for all patients. Visceral metastasis was observed in 12 patients (24%). The objective response rate, median progression-free survival and median cancer-specific survival were 61%, 9 and 26 months in the entire cohort, respectively. The higher highest maximum standardized uptake value was significantly associated with a lower objective response rate, shorter progression-free survival and shorter cancer-specific survival (P = 0.01, <0.001 and 0.004, respectively). On multivariate analyses, the highest maximum standardized uptake value was an independent predictor for all end-points. In the multivariate models for cancer-specific survival, the C-index improved from 0.559 to 0.601 and from 0.604 to 0.652 by adding the highest maximum standardized uptake value to the parameter set of the Bajorin model and Apolo model, respectively. Conclusions: Higher fluorodeoxyglucose uptake in metastases was significantly and independently associated with poor chemosensitivity and worse survival outcomes. Fluorodeoxyglucose positron emission tomography/computed tomography might aid in patient counseling and treatment decisions for metastatic urothelial carcinoma patients.

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PET/CT in Renal, Bladder, and Testicular Cancer

Bouchelouche

Choyke

2020

Clinical Nuclear Medicine

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Detection of Lymph Node Metastasis in Patients with Bladder Cancer using Maximum Standardised Uptake Value and 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Results from a High-volume Centre Including Long-term Follow-up

Cited by 47 publications

References 15 publications

Metastatic non-muscle invasive bladder cancer with cervical lymph node metastasis

Metastatic non-muscle invasive bladder cancer with cervical lymph node metastasis

Impact of fluorodeoxyglucose uptake on positron emission tomography/computed tomography on chemosensitivity and survival in patients with metastatic urothelial carcinoma

PET/CT in Renal, Bladder, and Testicular Cancer

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