Skip to main content

Advertisement

SpringerLink
Log in

18F-FDG PET/CT delayed images with forced diuresis for revaluating abdominopelvic malignancies

  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this retrospective study was to evaluate the role of delayed images after forced diuresis coupled with oral hydration in abdominopelvic 18F-FDG PET/CT.

Materials and methods

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 standard 18F-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).

Results

On initial PET/CT, the glucose metabolism characters of lesions were disguised by radioactive urine, or some undetermined 18F-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 excreted 18F-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.

Conclusion

Detection of abdominopelvic malignancies can be improved using delayed 18F-FDG PET/CT images after a diuretic and oral hydration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Nabi HA, Zubeldia JM (2002) Clinical applications of (18) F-FDG in oncology. J Nucl Med Technol 30:3–9

    PubMed  Google Scholar 

  2. De Gaetano AM, Calcagni ML, Rufini V, et al. (2009) Imaging of gynecologic malignancies with FDG PET-CT: case examples, physiologic activity, and pitfalls. Abdom Imaging 34:696–711

    Article  Google Scholar 

  3. Subhas N, Patel PV, Pannu HK, et al. (2005) Imaging of pelvic malignancies with in-line FDG PET-CT: case examples and common pitfalls of FDG PET. Radiographics 25:1031–1043

    Article  Google Scholar 

  4. Abouzied MM, Crawford ES, Nabi HA (2005) 18F-FDG imaging: pitfalls and artifacts. J Nucl Med Technol 33:145–155

    PubMed  Google Scholar 

  5. Anjos DA, Etchebehere EC, Ramos CD, et al. (2007) 18F-FDG PET/CT delayed images after diuretic for restaging invasive bladder cancer. J Nucl Med 11:764–770

    Article  Google Scholar 

  6. Kamel EM, Jichlinski P, Prior JO, et al. (2006) Forced diuresis improves the diagnostic accuracy of 18F-FDG PET in abdominopelvic malignancies. J Nucl Med 47:1803–1807

    CAS  PubMed  Google Scholar 

  7. Nijjar S, Patterson J, Ducharme J, Leslie WD, Demeter SJ (2010) The effect of furosemide dose timing on bladder activity in oncological imaging with 18F-fluorodeoxyglucose PET/CT. Nucl Med Commun 31:167–172

    Article  CAS  Google Scholar 

  8. Ceriani L, Suriano S, Ruberto T, Giovanella L (2011) Could different hydration protocols affect the quality of 18F-FDG PET/CT images? J Nucl Med Technol 39:77–82

    Article  Google Scholar 

  9. Gallagher BM, Fowler JS, Gutterson NI, et al. (1978) Metabolic trapping as a principle of radiopharmaceutical design: some factors responsible for the biodistribution of [18F] 2-deoxy-2-fluoro-d-glucose. J Nucl Med 19:1154–1161

    CAS  PubMed  Google Scholar 

  10. Kumar R, Zhuang H, Alavi A (2004) PET in the management of urologic malignancies. Radiol Clin N Am 42:1141–1153

    Article  Google Scholar 

  11. Koyama K, Okamura T, Kawabe J, et al. (2003) Evaluation of 18F-FDG PET with bladder irrigation in patients with uterine and ovarian tumors. J Nucl Med 44:353–358

    PubMed  Google Scholar 

  12. Kosuda S, Kison PV, Greenough R, Grossman HB, Wahl RL (1997) Preliminary assessment of fluorine-18 fluorodeoxyglucose positron emission tomography in patients with bladder cancer. Eur J Nucl Med 24:615–620

    CAS  PubMed  Google Scholar 

  13. Flamen P, Stroobants S, Van Cutsem E, et al. (1999) Additional value of whole-body positron emission tomography with fluorine-18-2-fluoro-2-deoxy-d-glucose in recurrent colorectal cancer. J Clin Oncol 17:894–901

    Article  CAS  Google Scholar 

  14. Miraldi F, Vesselle H, Faulhaber PF, Adler LP, Leisure GP (1998) Elimination of artifactual accumulation of FDG in PET imaging of colorectal cancer. Clin Nucl Med 23:3–7

    Article  CAS  Google Scholar 

  15. Yang Z, Cheng J, Pan L, et al. (2012) Is whole-body fluorine-18 fluorodeoxyglucose PET/CT plus additional pelvic images (oral hydration-voiding-refilling) useful for detecting recurrent bladder cancer? Ann Nucl Med 26:571–577

    Article  Google Scholar 

  16. Boubaker A, Prior J, Antonescu C, et al. (2001) F + 0 renography in neonates and infants younger than 6 months: an accurate method to diagnose severe obstructive uropathy. J Nucl Med 42:1780–1788

    CAS  PubMed  Google Scholar 

  17. Liu Y, Ghesani NV, Skurnick JH, Zuckier LS (2005) The F + 0 protocol for diuretic renography results in fewer interrupted studies due to voiding than the F-15 protocol. J Nucl Med 46:1317–1320

    PubMed  Google Scholar 

  18. Mertens LS, Fioole-Bruining A, Vegt E, et al. (2012) Detecting primary bladder cancer using delayed 18F-2-fluoro-2-deoxy-d-glucose- positron emission tomography/computed tomography imaging after forced diuresis. Indian J Nucl Med 27:145–150

    PubMed  PubMed Central  Google Scholar 

  19. Nayak B, Dogra PN, Naswa N, Kumar R (2013) Diuretic 18F-FDG PET/CT imaging for detection and locoregional staging of urinary bladder cancer: prospective evaluation of a novel technique. Eur J Nucl Med Mol Imaging 40:214–221

    Article  Google Scholar 

  20. Tsai SC, Ou YC, Cheng CL, et al. (2015) Reduction of bladder activity on FDG PET/CT scan in patients with urinary bladder carcinoma. A prospective study with a patient-friendly protocol. Nuklearmedizin 54:36–42

    Article  Google Scholar 

  21. Coquan E, Lasnon C, Joly F, et al. (2014) Diuretic 18F-FDG PET/CT for therapy monitoring in urothelial bladder cancer. Eur J Nucl Med Mol Imaging 41:1818–1819

    Article  Google Scholar 

  22. Agarwal KK, Roy SG, Kumar R (2016) Diuretic 18F-Fluorodeoxyglucose PET/computed tomography in evaluation of genitourinary malignancies. PET Clin 11:39–46

    Article  Google Scholar 

  23. Chen CJ, Chao TB, Shih DF (2010) Recurrent colon cancer involving the urinary bladder identified with F-18 FDG PET/CT after forced diuresis. Clin Nucl Med 35:258–259

    Article  Google Scholar 

  24. Kao PF, Ting WC, Hsiao PC, et al. (2013) Dynamic FDG PET/CT imaging with diuresis demonstrates an enterovesical fistula in a lymphoma patient with repeated colon diverticulitis. Clin Nucl Med 38:588

    Google Scholar 

  25. Yildirim-Poyraz N, Ozdemir E, Uzun B, Turkolmez S (2013) Dual phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography with forced diuresis in diagnostic imaging evaluation of bladder cancer. Rev Esp Med Nucl Imagen Mol 32:214–221

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. PET/CT Center, Gansu Provincial Hospital, 204 West Donggang Road, Lanzhou, 730000, Gansu, China

    Hui-Chun Wang, Yu-Bin Wang, Xiao-Hong Chen & Lan-Lan Cui

  2. Department of Radiology, Gansu Provincial Hospital, Lanzhou, China

    Zhi-Min Wang

Authors
  1. Hui-Chun Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhi-Min Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu-Bin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiao-Hong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lan-Lan Cui
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hui-Chun Wang.

Ethics declarations

Funding

No funding was received for this study.

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, HC., Wang, ZM., Wang, YB. et al. 18F-FDG PET/CT delayed images with forced diuresis for revaluating abdominopelvic malignancies. Abdom Radiol 42, 1415–1423 (2017). https://doi.org/10.1007/s00261-016-1030-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-016-1030-2

Keywords

Search

Navigation