title: Is whole-body fluorine-18 fluorodeoxyglucose PET/CT plus additional pelvic images (oral hydration-voiding-refilling) useful for detecting recurrent bladder cancer?
abstract: OBJECTIVE
  Because of the urinary excretion of fluorine-18 fluorodeoxyglucose ((18)F-FDG), FDG-PET or PET/CT is thought of little value in patients with bladder cancer. The purpose of our study was to investigate the value of (18)F-FDG PET/CT with additional pelvic images in detection of recurrent bladder cancers.
  
  
  METHODS
  From December 2006 to August 2010, 35 bladder cancer patients (median age 56 years old, ranging from 35 to 96) underwent routine (18)F-FDG PET/CT. To better detect bladder lesions, a new method called as oral hydration-voiding-refilling was introduced, which included that all the patients firstly received oral hydration, then were required to void frequently and finally were demanded to hold back urine when the additional pelvic images were scanned. Lesions were confirmed by either histopathology or clinical follow-up for at least 6 months.
  
  
  RESULTS
  Finally, 12 recurrent cases of 35 patients were confirmed by cystoscope. PET/CT correctly detected 11 of them. Among these 11 true positive patients, 5 patients (45.5 %) were detected only after additional pelvic images. Lichenoid lesions on the bladder wall were missed, which caused 1 false negative result. All three false positive cases were testified to be inflammatory tissues by cystoscope. Therefore, the sensitivity, specificity and accuracy of PET/CT were 91.7 % (11/12), 87.0 % (20/23) and 88.6 % (31/35), respectively.
  
  
  CONCLUSIONS
  PET/CT with additional pelvic images can highly detect recurrent lesions in residual bladder tissues. Our method with high accuracy and better endurance could be potentially applied.
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No. 270, Dong'an Road, Xuhui, Shanghai, 200032, China.
authors: Zhongyi
authors: Z
authors: Yang
authors: Jingyi
authors: J
authors: Cheng
authors: Lingling
authors: L
authors: Pan
authors: Silong
authors: S
authors: Hu
authors: Junyan
authors: J
authors: Xu
authors: Yongping
authors: Y
authors: Zhang
authors: Mingwei
authors: M
authors: Wang
authors: Jianping
authors: J
authors: Zhang
authors: Dingwei
authors: D
authors: Ye
authors: Yingjian
authors: Y
authors: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D051598:Whole Body Imaging
chemical_list: D019788:Fluorodeoxyglucose F18