title: Clinical Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Upper Tract Urothelial Carcinoma: Impact on Detection of Metastases and Patient Management.
abstract: OBJECTIVE
  To determine the diagnostic accuracy of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting metastasis and its impact on patient management with upper tract urothelial carcinoma (UTUC).
  
  
  METHODS
  Consecutive patients with UTUC underwent 18F-FDG PET/CT after CT for initial staging (n = 47) and for restaging at recurrence (n = 9). Diagnostic accuracy for detecting metastases with PET/CT and CT was compared statistically. The impact of PET/CT on patient management was assessed by comparing questionnaires that were completed by the attending physicians before and after PET/CT.
  
  
  RESULTS
  In the lesion-based analysis, 142 lesions were diagnosed as metastases. The sensitivity of PET/CT was significantly better than that of CT (85 vs. 50%, p = 0.0001). In the patient-based analysis, 22 patients were diagnosed as having metastases. The sensitivity/specificity/accuracy of PET/CT tended to be superior to those of CT, but these values were not significantly different (95, 91, and 93% vs. 82, 85, and 84%; p = 0.25, 0.50, and 0.063, respectively). The clinicians changed their assessments of disease extent and management plans in 18 (32%) and 11 (20%) patients, respectively, based on the PET/CT results.
  
  
  CONCLUSIONS
  The diagnostic accuracy of PET/CT for detecting metastasis was superior to that of CT. PET/CT provided additional information to the CT-based staging, which had an impact on patient management.
authors.affiliation: Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Tanaka
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yoshida
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Komai
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sakai
authors.forename: Shinji
authors.initials: S
authors.lastname: Urakami
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yuasa
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Masuda
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Koizumi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kohno
authors.forename: Iwao
authors.initials: I
authors.lastname: Fukui
authors.forename: Junji
authors.initials: J
authors.lastname: Yonese
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000737:chemistry*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging / Q000379:methods; D000072078:Positron Emission Tomography Computed Tomography; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D019459:Urothelium / Q000473:pathology*
chemical_list: D019788:Fluorodeoxyglucose F18