Use of F-18 FDG PET/CT Through Delayed Diuretic Imaging for Preoperative Evaluation of Upper Urinary Tract-Occupying Lesions

Overview

Journal Front Oncol

Specialty Oncology

Date 2021 Sep 16

PMID 34527577

Citations 1

Authors

Jun Wang

Liang Zhang

Jian Guo Wu

Ruohua Chen

Jia Lin Shen

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the value of F-18 FDG PET/CT in the differentiation of malignant and benign upper urinary tract-occupying lesions.

Patients And Methods: 64 patients with upper urinary tract-occupying lesions underwent F-18 FDG PET/CT at RenJi Hospital from January 2015 to February 2019 in this retrospective study. Of the 64 patients, 50 patients received nephroureterectomy or partial ureterectomy; 14 patients received ureteroscopy and biopsy. The comparisons of PET/CT parameters and clinical characteristics between malignant and benign upper urinary tract-occupying lesions were investigated.

Results: Of the 64 patients, 49 were found to have malignant tumors. Receiver operating characteristic analysis determined the lesion SUVmax value of 6.75 as the threshold for predicting malignant tumors. There were significant associations between malignant and benign upper urinary tract-occupying lesions and SUVmax of lesion (P<0.001), lesion size (P<0.001), and patient age (P=0.011). Multivariate analysis showed that SUVmax of lesion (P=0.042) and patient age (P=0.009) as independent predictors for differentiation of malignant from benign upper urinary tract-occupying lesions. There was a significant difference in tumor size between the positive (SUVmax >6.75) and negative (SUVmax ≤6.75) PET groups in 38 of the 49 patients with malignant tumors.

Conclusion: The SUVmax of lesion and patient age is associated with the nature of upper urinary tract-occupying lesions. F-18 FDG PET/CT may be useful to distinguish between malignant and benign upper urinary tract-occupying lesions and determine a suitable therapeutic strategy.

Citing Articles

Diagnostic Performance and Interobserver Agreement of Diuretic 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Upper Urinary Tract Cancer.

Shimamoto T, Karashima T, Nogami M, Inoue K, Yamagami T Cureus. 2024; 16(8):e68160.

PMID: 39350853 PMC: 11440008. DOI: 10.7759/cureus.68160.

References

Yeh C, Chen S, Chen Y . Delayed diuretic FDG PET/CT scan facilitates detection of renal urothelial cell carcinoma. Clin Nucl Med. 2009; 34(11):829-30. DOI: 10.1097/RLU.0b013e3181b81df4. View

Chen R, Wang Y, Zhou X, Huang G, Liu J . Preoperative PET/CT F-FDG Standardized Uptake by Lymph Nodes as a Significant Prognostic Factor in Patients with Colorectal Cancer. Contrast Media Mol Imaging. 2018; 2018:5802109. PMC: 6236575. DOI: 10.1155/2018/5802109. View

Chen R, Chen Y, Liu L, Zhou X, Liu J, Huang G . The Role of ¹⁸F-FDG PET/CT in the Evaluation of Peritoneal Thickening of Undetermined Origin. Medicine (Baltimore). 2016; 95(15):e3023. PMC: 4839790. DOI: 10.1097/MD.0000000000003023. View

Zamboni S, Foerster B, Abufaraj M, Seisen T, Roupret M, Colin P . Incidence and survival outcomes in patients with upper urinary tract urothelial carcinoma diagnosed with variant histology and treated with nephroureterectomy. BJU Int. 2019; 124(5):738-745. DOI: 10.1111/bju.14751. View

Razik A, Das C, Sharma S . PET-CT and PET-MR in urological cancers other than prostate cancer: An update on state of the art. Indian J Urol. 2018; 34(1):20-27. PMC: 5769244. DOI: 10.4103/iju.IJU_321_17. View

Baard J, de Bruin D, Zondervan P, Kamphuis G, de la Rosette J, Laguna M . Diagnostic dilemmas in patients with upper tract urothelial carcinoma. Nat Rev Urol. 2016; 14(3):181-191. DOI: 10.1038/nrurol.2016.252. View

Kunikowska J, Matyskiel R, Toutounchi S, Grabowska-Derlatka L, Koperski L, Krolicki L . What parameters from 18F-FDG PET/CT are useful in evaluation of adrenal lesions?. Eur J Nucl Med Mol Imaging. 2014; 41(12):2273-80. PMC: 4226932. DOI: 10.1007/s00259-014-2844-1. View

Sanguedolce F, Russo D, Mancini V, Selvaggio O, Calo B, Carrieri G . Prognostic and therapeutic role of HER2 expression in micropapillary carcinoma of the bladder. Mol Clin Oncol. 2019; 10(2):205-213. PMC: 6327213. DOI: 10.3892/mco.2018.1786. View

Keeley F, Kulp D, Bibbo M, McCue P, Bagley D . Diagnostic accuracy of ureteroscopic biopsy in upper tract transitional cell carcinoma. J Urol. 1997; 157(1):33-7. View

10.

Anjos D, Etchebehere E, Ramos C, Santos A, Albertotti C, Camargo E . 18F-FDG PET/CT delayed images after diuretic for restaging invasive bladder cancer. J Nucl Med. 2007; 48(5):764-70. DOI: 10.2967/jnumed.106.036350. View

11.

Chen R, Zhou X, Liu J, Huang G . Relationship between the expression of PD-1/PD-L1 and F-FDG uptake in bladder cancer. Eur J Nucl Med Mol Imaging. 2019; 46(4):848-854. DOI: 10.1007/s00259-018-4208-8. View

12.

Mowatt G, Zhu S, Kilonzo M, Boachie C, Fraser C, Griffiths T . Systematic review of the clinical effectiveness and cost-effectiveness of photodynamic diagnosis and urine biomarkers (FISH, ImmunoCyt, NMP22) and cytology for the detection and follow-up of bladder cancer. Health Technol Assess. 2010; 14(4):1-331, iii-iv. DOI: 10.3310/hta14040. View

13.

Cutress M, Stewart G, Zakikhani P, Phipps S, Thomas B, Tolley D . Ureteroscopic and percutaneous management of upper tract urothelial carcinoma (UTUC): systematic review. BJU Int. 2012; 110(5):614-28. DOI: 10.1111/j.1464-410X.2012.11068.x. View

14.

Cutress M, Stewart G, Tudor E, Egong E, Wells-Cole S, Phipps S . Endoscopic versus laparoscopic management of noninvasive upper tract urothelial carcinoma: 20-year single center experience. J Urol. 2012; 189(6):2054-60. DOI: 10.1016/j.juro.2012.12.006. View

15.

Huo J, Chu Y, Chamie K, Smaldone M, Boorjian S, Baillargeon J . Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer. Clin Genitourin Cancer. 2017; . PMC: 5878135. DOI: 10.1016/j.clgc.2017.07.018. View

16.

Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester R, Burger M . European Association of Urology Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma: 2015 Update. Eur Urol. 2015; 68(5):868-79. DOI: 10.1016/j.eururo.2015.06.044. View

17.

Zhou X, Chen R, Xie W, Ni Y, Liu J, Huang G . Relationship between 18F-FDG accumulation and lactate dehydrogenase A expression in lung adenocarcinomas. J Nucl Med. 2014; 55(11):1766-71. DOI: 10.2967/jnumed.114.145490. View

18.

Lotan Y, Roehrborn C . Sensitivity and specificity of commonly available bladder tumor markers versus cytology: results of a comprehensive literature review and meta-analyses. Urology. 2003; 61(1):109-18; discussion 118. DOI: 10.1016/s0090-4295(02)02136-2. View

19.

Kirkali Z, Tuzel E . Transitional cell carcinoma of the ureter and renal pelvis. Crit Rev Oncol Hematol. 2003; 47(2):155-69. DOI: 10.1016/s1040-8428(03)00079-9. View

20.

Vashistha V, Shabsigh A, Zynger D . Utility and diagnostic accuracy of ureteroscopic biopsy in upper tract urothelial carcinoma. Arch Pathol Lab Med. 2013; 137(3):400-7. DOI: 10.5858/arpa.2012-0136-OA. View