The role of 18F-FDG PET/CT scan compared to CT-scan alone for lymph node staging before radical cystectomy in patients with bladder cancer.
18F-fluorodeoxyglucose positron emission tomography–computed tomography
Bladder cancer
Computed tomography
Pelvic lymph node
Radical cystectomy
Journal
Urologic oncology
ISSN: 1873-2496
Titre abrégé: Urol Oncol
Pays: United States
ID NLM: 9805460
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
01
02
2021
revised:
09
04
2021
accepted:
17
04
2021
pubmed:
2
6
2021
medline:
10
2
2022
entrez:
1
6
2021
Statut:
ppublish
Résumé
Accurate Lymph node (LN) staging before radical cystectomy (RC) in patients with bladder cancer (BC) is crucial to improve patient's management. 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET-CT) become widely used in the loco-regional staging of BC. The diagnostic performance of PET-CT in preoperative LN staging of BC is still unknown due to lacking large trials. We aim to evaluate the diagnostic value of PET-CT scan, compared with CT scan alone for preoperative LN staging of BC. From January 2010 to November 2020, we retrospectively reviewed the records of 300 patients undergoing RC for muscle-invasive BC and high-risk non-muscle-invasive BC. All patients had PET-CT and CT of abdomen and pelvis to assess for pelvic LN metastases before RC. Patients were excluded from analysis if they had neoadjuvant chemotherapy (NAC). Sensitivity, specificity, and accuracy for detecting pelvic LN metastases were determined by comparing the results of the FDG PET-CT and CT alone to the final histopathology reports obtained after RC. LN metastasis was confirmed histology in 134 patients (44.7%). On a patient-based analysis, PET-CT, and CT showed a sensitivity of 40.3% and 13.4 %, respectively, a specificity of 79.5% and 86.7 %, respectively, positive predictive value (PPV) of 61.4% and 45%, respectively, and negative predictive value (NPV) of 62.3% and 55.4%, respectively. The diagnostic accuracy of PET-CT scan depends on multiple preoperative and postoperative factors. PET-CT is more accurate than CT-scan alone for preoperative LN staging in patients with BC.
Sections du résumé
BACKGROUND
Accurate Lymph node (LN) staging before radical cystectomy (RC) in patients with bladder cancer (BC) is crucial to improve patient's management. 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET-CT) become widely used in the loco-regional staging of BC. The diagnostic performance of PET-CT in preoperative LN staging of BC is still unknown due to lacking large trials.
OBJECTIVES
We aim to evaluate the diagnostic value of PET-CT scan, compared with CT scan alone for preoperative LN staging of BC.
PATIENTS AND METHODS
From January 2010 to November 2020, we retrospectively reviewed the records of 300 patients undergoing RC for muscle-invasive BC and high-risk non-muscle-invasive BC. All patients had PET-CT and CT of abdomen and pelvis to assess for pelvic LN metastases before RC. Patients were excluded from analysis if they had neoadjuvant chemotherapy (NAC). Sensitivity, specificity, and accuracy for detecting pelvic LN metastases were determined by comparing the results of the FDG PET-CT and CT alone to the final histopathology reports obtained after RC.
RESULTS
LN metastasis was confirmed histology in 134 patients (44.7%). On a patient-based analysis, PET-CT, and CT showed a sensitivity of 40.3% and 13.4 %, respectively, a specificity of 79.5% and 86.7 %, respectively, positive predictive value (PPV) of 61.4% and 45%, respectively, and negative predictive value (NPV) of 62.3% and 55.4%, respectively. The diagnostic accuracy of PET-CT scan depends on multiple preoperative and postoperative factors.
CONCLUSION
PET-CT is more accurate than CT-scan alone for preoperative LN staging in patients with BC.
Identifiants
pubmed: 34059435
pii: S1078-1439(21)00183-6
doi: 10.1016/j.urolonc.2021.04.027
pii:
doi:
Substances chimiques
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
833.e9-833.e17Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.