title: FDG-PET/CT as a post-treatment restaging tool in urothelial carcinoma: Comparison with contrast-enhanced CT.
abstract: OBJECTIVE
  To assess the clinical usefulness of FDG-PET/CT in the diagnosis of recurrent and metastatic urothelial carcinoma in comparison with contrast-enhanced CT.
  
  
  METHODS
  Eighty-three patients who had undergone treatment for histopathologically proven urothelial carcinoma underwent whole-body FDG-PET/CT and contrast-enhanced CT for suspected recurrence within a time interval of two weeks. Patient-based analysis and lesion sites besides the urinary tract, as interpreted by two experienced readers, were compared between the two modalities using McNemar test. Lesion status was determined on the basis of histopathology, radiological imaging and clinical follow-up for longer than 6 months.
  
  
  RESULTS
  Patient-based analysis showed that the sensitivity, specificity, and accuracy of FDG-PET/CT were 97.4%, 93.3% and 95.2%, respectively, whereas those of contrast-enhanced CT were 86.8%, 93.3% and 90.4%, respectively. The sensitivity and accuracy of FDG-PET/CT were higher than contrast-enhanced CT without significant difference (p=0.13). The sensitivity of FDG-PET/CT for diagnosis of bone metastasis was significantly higher than that of contrast-enhanced CT (93.8% vs. 25%, p=0.0026).
  
  
  CONCLUSIONS
  FDG-PET/CT is a more accurate modality than CT for assessment of recurrence outside the urinary tract in patients with urothelial carcinoma, especially for bone lesion. Cystoscopy, urine cytology, and FDG-PET/CT are complementary procedures and may have a definite management role.
authors: Department of Nuclear Medicine and PET Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: kazu10041976@yahoo.co.jp.
authors: Kazuhiro
authors: K
authors: Kitajima
authors: Department of Urology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: shingoy@hyo-med.ac.jp.
authors: Shingo
authors: S
authors: Yamamoto
authors: Department of Nuclear Medicine and PET Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: fukuchan0106@gmail.com.
authors: Kazuhito
authors: K
authors: Fukushima
authors: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: ko-yamakado@hyo-med.ac.jp.
authors: Koichiro
authors: K
authors: Yamakado
authors: Department of Nuclear Medicine and PET Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: t-katsu@hyo-med.ac.jp.
authors: Takayuki
authors: T
authors: Katsuura
authors: Department of Nuclear Medicine and PET Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: y-iga@hyo-med.ac.jp.
authors: Yoko
authors: Y
authors: Igarashi
authors: Department of Nuclear Medicine and PET Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: n_you_634@yahoo.co.jp.
authors: Yusuke
authors: Y
authors: Kawanaka
authors: Department of Nuclear Medicine and PET Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: m-mou@hyo-med.ac.jp.
authors: Miya
authors: M
authors: Mouri
authors: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan. Electronic address: hirota-s@hyo-med.ac.jp.
authors: Shozo
authors: S
authors: Hirota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D019459:Urothelium / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG; PET/CT; Restaging; Urothelial carcinoma