Integrated analysis of 18F-FDG PET/CT improves preoperative lymph node staging for patients with invasive bladder cancer View Full Text


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Article Info

DATE

2019-01-21

AUTHORS

Antoine Girard, Mathieu Rouanne, Sarah Taconet, Camélia Radulescu, Yann Neuzillet, Astrid Girma, Aurélie Beaufrere, Thierry Lebret, Elise Le Stanc, Jean-François Grellier

ABSTRACT

ObjectivesPreoperative 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is controversial to assess lymph node (LN) staging in patients with invasive bladder cancer. We proposed to use the maximum standardized uptake value (SUVmax) associated with axial-based LN size to improve the detection of regional LN metastasis.MethodsFrom May 2015 to May 2017, we prospectively included patients with urothelial bladder cancer who underwent radical cystectomy with extended pelvic LN dissection. All patients underwent preoperative 18F-FDG PET/CT staging before surgery. The gold standard comparator was the pathological examination of resected LNs. The data were reported on a regional per area- and patient-based model according to SUVmax values and axial-based LN size criteria.ResultsIn total, 1012 LNs were identified in 61 patients with clinically localized invasive bladder cancer who underwent radical cystectomy and extended pelvic LN dissection. Loco-regional involvement of 24 LN areas was confirmed in 17 patients. In per area analysis, diagnostic accuracy of PET/CT and CT alone were respectively 84% and 78% (p = 0.039). On patient-based analysis, combined PET/CT correctly classified pelvic LN status in 5/61 (+ 8%) additional patients using optimal thresholds compared to CT alone, with accuracies of 82% and 74%, respectively (p = 0.13).ConclusionCombining SUVmax and axial-based LN size criteria using 18F-FDG PET/CT improved the diagnostic accuracy for preoperative LN staging in patients with invasive bladder cancer, in per area analysis.Key Points• Combining metabolical and morphological features using18F-FDG PET/CT improves the detection of malignant lymph node in patients with bladder cancer.•18F-FDG PET/CT may help for initial staging of patients with muscle invasive bladder cancer. More... »

PAGES

4286-4293

References to SciGraph publications

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  • 2016-02-04. The diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography and computed tomography in staging bladder cancer: a single-institution study and a systematic review with meta-analysis in WORLD JOURNAL OF UROLOGY
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  • 2017-02-08. An evaluation of morphological and functional multi-parametric MRI sequences in classifying non-muscle and muscle invasive bladder cancer in EUROPEAN RADIOLOGY
  • 2001-06-01. ADASP Recommendations for Processing and Reporting of Lymph Node Specimens Submitted for Evaluation of Metastatic Disease in MODERN PATHOLOGY
  • 2017-04-13. Bladder cancer in NATURE REVIEWS DISEASE PRIMERS
  • 2012-07-05. Is whole-body fluorine-18 fluorodeoxyglucose PET/CT plus additional pelvic images (oral hydration–voiding–refilling) useful for detecting recurrent bladder cancer? in ANNALS OF NUCLEAR MEDICINE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00330-018-5959-0

    DOI

    http://dx.doi.org/10.1007/s00330-018-5959-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111577182

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30666449


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        "description": "ObjectivesPreoperative 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is controversial to assess lymph node (LN) staging in patients with invasive bladder cancer. We proposed to use the maximum standardized uptake value (SUVmax) associated with axial-based LN size to improve the detection of regional LN metastasis.MethodsFrom May 2015 to May 2017, we prospectively included patients with urothelial bladder cancer who underwent radical cystectomy with extended pelvic LN dissection. All patients underwent preoperative 18F-FDG PET/CT staging before surgery. The gold standard comparator was the pathological examination of resected LNs. The data were reported on a regional per area- and patient-based model according to SUVmax values and axial-based LN size criteria.ResultsIn total, 1012 LNs were identified in 61 patients with clinically localized invasive bladder cancer who underwent radical cystectomy and extended pelvic LN dissection. Loco-regional involvement of 24 LN areas was confirmed in 17 patients. In per area analysis, diagnostic accuracy of PET/CT and CT alone were respectively 84% and 78% (p\u2009=\u20090.039). On patient-based analysis, combined PET/CT correctly classified pelvic LN status in 5/61 (+\u20098%) additional patients using optimal thresholds compared to CT alone, with accuracies of 82% and 74%, respectively (p\u2009=\u20090.13).ConclusionCombining SUVmax and axial-based LN size criteria using 18F-FDG PET/CT improved the diagnostic accuracy for preoperative LN staging in patients with invasive bladder cancer, in per area analysis.Key Points\u2022 Combining metabolical and morphological features using18F-FDG PET/CT improves the detection of malignant lymph node in patients with bladder cancer.\u202218F-FDG PET/CT may help for initial staging of patients with muscle invasive bladder cancer.", 
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    32 schema:description ObjectivesPreoperative 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is controversial to assess lymph node (LN) staging in patients with invasive bladder cancer. We proposed to use the maximum standardized uptake value (SUVmax) associated with axial-based LN size to improve the detection of regional LN metastasis.MethodsFrom May 2015 to May 2017, we prospectively included patients with urothelial bladder cancer who underwent radical cystectomy with extended pelvic LN dissection. All patients underwent preoperative 18F-FDG PET/CT staging before surgery. The gold standard comparator was the pathological examination of resected LNs. The data were reported on a regional per area- and patient-based model according to SUVmax values and axial-based LN size criteria.ResultsIn total, 1012 LNs were identified in 61 patients with clinically localized invasive bladder cancer who underwent radical cystectomy and extended pelvic LN dissection. Loco-regional involvement of 24 LN areas was confirmed in 17 patients. In per area analysis, diagnostic accuracy of PET/CT and CT alone were respectively 84% and 78% (p = 0.039). On patient-based analysis, combined PET/CT correctly classified pelvic LN status in 5/61 (+ 8%) additional patients using optimal thresholds compared to CT alone, with accuracies of 82% and 74%, respectively (p = 0.13).ConclusionCombining SUVmax and axial-based LN size criteria using 18F-FDG PET/CT improved the diagnostic accuracy for preoperative LN staging in patients with invasive bladder cancer, in per area analysis.Key Points• Combining metabolical and morphological features using18F-FDG PET/CT improves the detection of malignant lymph node in patients with bladder cancer.•18F-FDG PET/CT may help for initial staging of patients with muscle invasive bladder cancer.
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