title: 18F-FDG PET/CT delayed images with forced diuresis for revaluating abdominopelvic malignancies.
abstract: The aim of this retrospective study was to evaluate the role of delayed images after forced diuresis coupled with oral hydration in abdominopelvic18F-FDG PET/CT.
  
  
  
  Forty-six patients consisting of 17 urological diseases, 9 gynecological tumors, 18 colorectal malignancies, and 2 cancers of unknown primary site were retrospectively analyzed. All patients who presented with indeterminate or equivocal abdominopelvic foci on standard18F-FDG PET/CT underwent a delayed abdominopelvic imaging after administration of 20 mg furosemide intravenously and extra water intake of 500 mL. PET/CT images before and after furosemide were compared with each other and their findings correlated with pathology or clinical follow-up (>6 months).
  
  
  
  On initial PET/CT, the glucose metabolism characters of lesions were disguised by radioactive urine, or some undetermined18F-FDG accumulating foci near the urinary tract appeared. While postdiuretic PET/CT demonstrated an excellent urinary tracer washout, and hypermetabolic lesions could be clearly detected and precisely localized in all cases. On the other hand, the suspected active foci caused by potential stagnation of excreted18F-FDG in urinary tract were eliminated. The sensitivity, specificity, and accuracy were 94.4% (34/36), 8/10, 91.3% (42/46), respectively. Furthermore, the additional lesions with surrounding invasion or locoregional metastasis were discovered in 8 of 46 (17.4%) patients only by the delayed images, including 2 gynecological and 6 rectal malignancies.
  
  
  
  Detection of abdominopelvic malignancies can be improved using delayed18F-FDG PET/CT images after a diuretic and oral hydration.
authors.affiliation: PET/CT Center, Gansu Provincial Hospital, 204 West Donggang Road, Lanzhou, 730000, Gansu, China. gssypetct@163.com.
authors.forename: Hui-Chun
authors.initials: HC
authors.lastname: Wang
authors.affiliation: Department of Radiology, Gansu Provincial Hospital, Lanzhou, China.
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Wang
authors.affiliation: PET/CT Center, Gansu Provincial Hospital, 204 West Donggang Road, Lanzhou, 730000, Gansu, China.
authors.forename: Yu-Bin
authors.initials: YB
authors.lastname: Wang
authors.affiliation: PET/CT Center, Gansu Provincial Hospital, 204 West Donggang Road, Lanzhou, 730000, Gansu, China.
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Chen
authors.affiliation: PET/CT Center, Gansu Provincial Hospital, 204 West Donggang Road, Lanzhou, 730000, Gansu, China.
authors.forename: Lan-Lan
authors.initials: LL
authors.lastname: Cui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D004232:Diuretics / Q000008:administration & dosage*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014565:Urogenital Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D004232:Diuretics; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005665:Furosemide
keywords: 18F-FDG PET/CT; Forced diuresis; Gynecological tumors; Oral hydration; Rectal cancers; Urological lesions