title: Role of fluorodeoxyglucose positron emission tomography/computed tomography in diagnostic evaluation of carcinoma urinary bladder: comparison with computed tomography.
abstract: Bladder carcinoma is the most frequent tumor of the urinary tract and accounts 7% of all malignancies in men and 2% of all malignancies in women. This retrospective study was carried out to assess the diagnostic utility of F18-fludeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the imaging evaluation of bladder carcinoma. Seventy-seven consecutive patients diagnosed to have carcinoma urinary bladder referred for F18-FDG PET/CT were included in this study. Thirty-four patients were for initial staging after transurethral biopsy and remaining 43 patients were for restaging. All patients also underwent CT scan of the abdomen and pelvis. PET/CT findings were correlated with diagnostic CT scan and histopathological findings. In 30 of the 34 patients for initial staging, both PET/CT and CT confirmed the primary lesion in the bladder. Histopathology report was available in 23 patients. Lymph nodes FDG uptake reported to be metastatic in 10/23 patients while CT detected lymph node metastasis in 12 patients. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy have been calculated to be 87.5%, 80%, 70%, 92%, 82% for PET/CT and 66%, 57%, 50%, 72%, 60% for CT respectively. PET/CT detected metastatic disease in 8 patients whereas CT detected in 4 patients. Of the 43 patients for restaging, local recurrence was detected in 24 patients on both PET/CT and CT. Histopathology report was available in 17 patients. Sensitivity, specificity, PPV, NPV and accuracy were 85%, 60%, 60%, 85%, 70% for PET/CT and 80%, 50%, 40%, 85%, 58% for CT respectively. Nineteen patients were detected to have metastatic disease by PET/CT, whereas CT detected metastases in 11 patients. F-18 FDG PET/CT is a very useful modality in pre-operative staging and monitoring after surgery, chemotherapy or radiotherapy of patients with carcinoma urinary bladder.
authors.affiliation: Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Dhritiman
authors.initials: D
authors.lastname: Chakraborty
authors.affiliation: Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Bhagwant Rai
authors.initials: BR
authors.lastname: Mittal
authors.affiliation: Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Raghava
authors.initials: R
authors.lastname: Kashyap
authors.affiliation: Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Utham Kumar
authors.initials: UK
authors.lastname: Mete
authors.affiliation: Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Narang
authors.affiliation: Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.affiliation: Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Anish
authors.initials: A
authors.lastname: Bhattacharya
authors.affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
authors.affiliation: Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Arup K
authors.initials: AK
authors.lastname: Mandal
keywords: Bladder carcinoma; fludeoxyglucose positron emission tomography/computed tomography; restaging; staging