Catheter-assisted 18F-FDG-PET/CT imaging of primary bladder cancer:  a prospective study.
OBJECTIVE
The purpose of this study was to prospectively investigate the value of a standardized 18F-fluorodeoxyglucose (18F-FDG)-PET/computed tomography (CT) protocol for imaging of primary bladder cancer, using standardized bladder flushing and filling.


METHODS
We included 19 patients with cT1-4 bladder cancer. A Foley catheter was inserted before 18F-FDG injection. PET/CT imaging was performed according to four bladder protocols: (1) bladder empty; (2) bladder empty after flushing; (3) bladder filled with 50 ml saline; and (4) bladder filled with 100 ml saline. Tumour visibility was assessed and compared with histopathology or CT and cystoscopy.


RESULTS
The procedure was successfully completed in 16 out of 19 patients. The reference standard revealed a bladder tumour in 16 out of 19 patients. Sensitivity of protocols 1 and 2 was 0.38 [95% confidence interval (CI), 0.16-0.64] compared with 0.63 (95% CI, 0.36-0.84) for protocols 3 and 4.


CONCLUSIONS
Flushing and subsequent retrograde filling of the bladder results in the highest rate of tumour visualization and quantification. Flushing alone is inferior.
Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. l.mertens@nki.nl
Laura S
LS
Mertens
Natascha M
NM
Bruin
Erik
E
Vegt
Willem M
WM
de Blok
Annemarie
A
Fioole-Bruining
Bas W
BW
van Rhijn
Simon
S
Horenblas
Wouter V
WV
Vogel
D000368:Aged; D057785:Catheters; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000295:instrumentation*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology
D019788:Fluorodeoxyglucose F18