title: Effect of furosemide administration before F-18 fluorodeoxyglucose positron emission tomography/computed tomography on urine radioactivity and detection of uterine cervical cancer.
abstract: BACKGROUND
  In evaluating uterine cervical cancer with ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), there may be overlap between the FDG activity at tumor sites and nonspecific radioactivity in the urine. We evaluated the efficacy of furosemide premedication with routine hydration to obtain better contrast and less overlap between cervical cancer and the urinary bladder.
  
  
  METHODS
  We retrospectively evaluated 166 patients who had primary or relapsed cervical cancer and underwent FDG PET/CT scanning with (133 patients) or without (33 patients) furosemide premedication (10 mg intravenous, slowly injected 30 min before the scan). We calculated bladder and tumor maximum and median standardized uptake value (SUVmax and SUVmed), and overlap between tumor and urinary activity was detected visually.
  
  
  RESULTS
  Overlap between urinary and tumor radioactivity was observed in 8 of 133 scans (6%) in patients who receive furosemide and in 3 of 33 scans (9%) in patients who did not receive furosemide. The SUVmax and SUVmed for the bladder were significantly lower in patients who were pretreated with furosemide (SUVmax, 6.3; SUVmed, 4.6) than patients who were not pretreated with furosemide (SUVmax, 8.8 [P ≤ 0.008]; SUVmed, 6.5 [P ≤ 0.002]). The tumor SUVmax and SUVmed were similar between the patient groups.
  
  
  CONCLUSIONS
  Furosemide premedication before FDG PET/CT scanning may enable improved evaluation of activity and extension of cervical cancer.
authors.affiliation: Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland. adamico@io.gliwice.pl.
authors.forename: Andrea
authors.initials: A
authors.lastname: d'Amico
authors.forename: Izabela
authors.initials: I
authors.lastname: Gorczewska
authors.forename: Kamil
authors.initials: K
authors.lastname: Gorczewski
authors.forename: Maria
authors.initials: M
authors.lastname: Turska-d'Amico
authors.forename: Marco
authors.initials: M
authors.lastname: Di Pietro
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D005665:Furosemide / Q000494:pharmacology*; D006801:Humans; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D011851:Radioactivity; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014556:Urine; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging*
chemical_list: D019788:Fluorodeoxyglucose F18; D005665:Furosemide