FDG-PET/CT for Assessing the Response to Neoadjuvant Chemotherapy in Bladder Cancer Patients

Soubra, Ayman; Gencturk, Mehmet; Balaji, Priya; Gupta, Shilpa; Jha, Gautam; Konety, Badrinath R.

doi:10.1016/j.clgc.2018.05.008

Cited by 39 publications

(29 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study evaluating delayed-time-point FDG-PET/CT performed within 1 month of initial transurethral resection in 79 patients found that residual tumors at subsequent confirmatory biopsy had higher mean and maximum SUV and greater lesional thickness when compared with inflammatory changes [51]. Following neoadjuvant chemotherapy in patients with MIBC, FDG-PET/CT demonstrated 75% sensitivity and 90% specificity in identifying patients with complete pathological response at cystectomy [58]. FDG-PET/CT is also accurate in distinguishing primary tumor downstaging from nonresponse in bladder cancer, which can have important implications in potential alterations of ineffective neoadjuvant chemotherapy regimens [59].…”

Section: Fdg-pet/ct For Neoadjuvant Chemotherapy Response and Restagingmentioning

confidence: 99%

The Role of Imaging in Bladder Cancer Diagnosis and Staging

et al. 2020

View full text Add to dashboard Cite

Bladder cancer (BC) is the most common cancer of the urinary tract in the United States. Imaging plays a significant role in the management of patients with BC, including the locoregional staging and evaluation for distant metastatic disease, which cannot be assessed at the time of cystoscopy and biopsy/resection. We aim to review the current role of cross-sectional and molecular imaging modalities for the staging and restaging of BC and the potential advantages and limitations of each imaging modality. CT is the most widely available and frequently utilized imaging modality for BC and demonstrates good performance for the detection of nodal and visceral metastatic disease. MRI offers potential value for the locoregional staging and evaluation of muscular invasion of BC, which is critically important for prognostication and treatment decision-making. FDG-PET/MRI is a novel hybrid imaging modality combining the advantages of both MRI and FDG-PET/CT in a single-setting comprehensive staging examination and may represent the future of BC imaging evaluation.

show abstract

Section: Fdg-pet/ct For Neoadjuvant Chemotherapy Response and Restagingmentioning

confidence: 99%

The Role of Imaging in Bladder Cancer Diagnosis and Staging

et al. 2020

View full text Add to dashboard Cite

show abstract

“…There have been a few studies that have focused on the performance of 18F-FDG PET/CT in monitoring the response of BC to NAC. In terms of primary bladder tumor evaluation after NAC, 18F-FDG PET/CT has demonstrated 75% sensitivity and 90% specificity in identifying patients with complete pathologic response (45). After induction chemotherapy in pelvic LN metastatic patients, responders were distinguished from nonresponders with a sensitivity of 83-100% and a specificity of 67-94% with 18F-FDG PET/CT, compared to 88 and 33%, respectively, with conventional CECT.…”

Section: Neoadjuvant or Induction Treatmentmentioning

confidence: 99%

The Role of 18F-FDG PET/CT in Guiding Precision Medicine for Invasive Bladder Carcinoma

et al. 2020

View full text Add to dashboard Cite

Bladder cancer (BC) is the 10th most common cancer worldwide. Approximately one quarter of patients with BC have muscle-invasive disease (MIBC). Muscle-invasive disease carries a poor prognosis and choosing the optimal treatment option is critical to improve patients’ outcomes. Ongoing research supports the role of 2-deoxy-2-(18F)fluoro- D -glucose positron emission tomography (18F-FDG PET) in guiding patient-specific management decisions throughout the course of MIBC. As an imaging modality, 18F-FDG PET is acquired simultaneously with either computed tomography (CT) or MRI to offer a hybrid approach combining anatomical and metabolic information that complement each other. At initial staging, 18F-FDG PET/CT enhances the detection of extravesical disease, particularly in patients classified as oligometastatic by conventional imaging. 18F-FDG PET/CT has value in monitoring response to neoadjuvant and systemic chemotherapy, as well as in localizing relapse after treatment. In the new era of immunotherapy, 18F-FDG PET/CT may also be useful to monitor treatment efficacy as well as to detect immune-related adverse events. With the advent of artificial intelligence techniques such as radiomics and deep learning, these hybrid medical images can be mined for quantitative data, providing incremental value over current standard-of-care clinical and biological data. This approach has the potential to produce a major paradigm shift toward data-driven precision medicine with the ultimate goal of personalized medicine. In this review, we highlight current literature reporting the role of 18F-FDG PET in supporting personalized management decisions for patients with MIBC. Specific topics reviewed include the incremental value of 18F-FDG PET in prognostication, pre-operative planning, response assessment, prediction of recurrence, and diagnosing drug toxicity.

show abstract

“…These analyses showed that h‐SUVmax was a significant and independent predictor of all end‐points: chemotherapy response, PFS and CSS. Although some previous studies addressed the clinical utility of assessing a decrease of FDG uptake in advanced UC, which could reflect the treatment response, this is the first study to show the impact of FDG uptake itself in metastatic lesions of UC on chemosensitivity and patient survival . The present results can be easily applied to clinical practice, and might help with patient counseling and treatment decisions.…”

Section: Discussionmentioning

confidence: 82%

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

et al. 2019

View full text Add to dashboard Cite

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.

show abstract

FDG-PET/CT for Assessing the Response to Neoadjuvant Chemotherapy in Bladder Cancer Patients

Cited by 39 publications

References 14 publications

The Role of Imaging in Bladder Cancer Diagnosis and Staging

The Role of Imaging in Bladder Cancer Diagnosis and Staging

The Role of 18F-FDG PET/CT in Guiding Precision Medicine for Invasive Bladder Carcinoma

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

Contact Info

Product

Resources

About