title: 18 F-fluorodeoxyglucose positron emission tomography-computed tomography for preoperative lymph node staging in patients undergoing radical cystectomy for bladder cancer: a prospective study.
abstract: OBJECTIVE
  The objective of our study was to analyze the diagnostic performance of (18) F-fluorodeoxyglucose positron emission tomography-computed tomography for lymph node staging in patients with bladder cancer before radical cystectomy and to compare it with that of computed tomography.
  
  
  METHODS
  A total of 52 patients operated on between 2005 and 2010 were prospectively included in this prospective, mono-institutional, open, non-randomized pilot study. Patients who had received neoadjuvant chemotherapy or radiotherapy were excluded. (18) F-fluorodeoxyglucose positron emission tomography-computed tomography in addition to computed tomography was carried out for lymph node staging of bladder cancer before radical cystectomy. Lymph node dissection during radical cystectomy was carried out. Findings from (18) F-fluorodeoxyglucose positron emission tomography-computed tomography and computed tomography were compared with the results of definitive histological examination of the lymph node dissection. The diagnostic performance of the two imaging modalities was assessed and compared.
  
  
  RESULTS
  The mean number of lymph nodes removed during lymph node dissection was 16.5 ± 10.9. Lymph node metastasis was confirmed on histological examination in 22 cases (42.3%). This had been suspected in five cases (9.6%) on computed tomography and in 12 cases (23.1%) on (18) F-fluorodeoxyglucose positron emission tomography-computed tomography. Sensitivity, specificity, positive predictive value, negative predictive value, relative risk and accuracy were 9.1%, 90%, 40%, 57.4%, 0.91 and 55.7%, respectively, for computed tomography, and 36.4%, 86.7%, 66.7%, 65%, 2.72, 65.4%, respectively, for (18) F-fluorodeoxyglucose positron emission tomography-computed tomography.
  
  
  CONCLUSIONS
  (18) F-fluorodeoxyglucose positron emission tomography-computed tomography is more reliable than computed tomography for preoperative lymph node staging in patients with invasive bladder carcinoma undergoing radical cystectomy.
authors.affiliation: Department of Urology Clinic, Nantes University Hospital Center, Nantes, France.
authors.forename: Maryam
authors.initials: M
authors.lastname: Hitier-Berthault
authors.forename: Catherine
authors.initials: C
authors.lastname: Ansquer
authors.forename: Julien
authors.initials: J
authors.lastname: Branchereau
authors.forename: Karine
authors.initials: K
authors.lastname: Renaudin
authors.forename: Françoise
authors.initials: F
authors.lastname: Bodere
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouchot
authors.forename: Jérôme
authors.initials: J
authors.lastname: Rigaud
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D015653:Cystectomy; D019788:Fluorodeoxyglucose F18; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D064847:Multimodal Imaging / Q000379:methods* / Q000592:standards; D009367:Neoplasm Staging / Q000379:methods; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-fluorodeoxyglucose positron emission tomography-computed tomography; bladder cancer; computed tomography; cystectomy; lymph node; staging