title: Utility of early dynamic and delayed post-diuretic18F-FDG PET/CT SUVmaxin predicting tumour grade and T-stage of urinary bladder carcinoma: results from a prospective single centre study.
abstract: OBJECTIVE
  Accurate pre-treatment grading and staging of bladder cancer are vital for better therapeutic decision and prognosis. The aim of the present study was to evaluate the correlation between maximum standardized uptake value (SUVmax) calculated during early dynamic and post-diuretic fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET)/CT studies with grade and pT-stage of bladder cancer.
  
  
  METHODS
  39 patients with suspected/proven bladder carcinoma underwent 10-min early dynamic pelvic imaging and delayed post-diuretic whole-body FDG PET/CT imaging. SUVmaxof the lesions derived from both studies was compared with grade and pT-stage. Relationship of SUVmaxwith grade and pT-stage was analyzed using independent sample t-test and analysis of variance.
  
  
  RESULTS
  SUVmaxof the early dynamic imaging showing tumour perfusion was independent from the SUVmaxof delayed imaging. High-grade tumours showed higher SUVmaxthan low-grade tumours in the early dynamic imaging (5.4 ± 1.4 vs 4.7 ± 1.6; p-value 0.144) with statistically significant higher value in Stage pT1 tumours (6.8 ± 0.8 vs 5.5 ± 1.2; p-value 0.04). Non-invasive pTa tumours had significantly less SUVmaxthan higher stage tumours during early dynamic imaging [F(4,29) = 6.860, p 0.001].
  
  
  CONCLUSIONS
  Early dynamic imaging may have a role in predicting the grade and aggressiveness of the bladder tumours and thus can help in treatment planning and prognostication. Advances in knowledge: Dynamic PET/CT is a limitedly explored imaging technique. This prospective pilot study demonstrates the utility of this modality as a potential adjunct to standard FDG PET/CT imaging in predicting the grade and aggressiveness of the bladder tumours and thus can impact the patient management.
authors.affiliation: 1 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Sharma
authors.affiliation: 2 Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Uttam K
authors.initials: UK
authors.lastname: Mete
authors.affiliation: 1 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ashwani
authors.initials: A
authors.lastname: Sood
authors.affiliation: 3 Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Nandita
authors.initials: N
authors.lastname: Kakkar
authors.affiliation: 1 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Arun K R
authors.initials: AK
authors.lastname: Gorla
authors.affiliation: 1 Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Bhagwant R
authors.initials: BR
authors.lastname: Mittal
mesh_terms: D004232:Diuretics; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*
chemical_list: D004232:Diuretics; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18