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Clinical Utility of 18F-FDG PET/CT Scanning in Urological Cancers Management

  • Xiang Zhou
  • Gang Huang
Chapter

Abstract

Positron emission tomography/computed tomography (PET/CT) has become an important method for the diagnosis/identification, staging, follow-up monitoring, and efficacy and prognosis determination of malignant tumors. The glucose analog 18F-deoxyglucose (FDG) is the most mature and widely used imaging agent for PET. Since most malignant cells show a high glucose metabolism, they can accumulate more 18F-FDG than do normal tissues and organs, which can be detected by PET/CT and distinguished from normal tissues. 18F-FDG-PET/CT imaging has good sensitivity and accuracy for the diagnosis and evaluation of most malignant tumors. However, 18F-FDG-PET/CT has limited application in primary urinary tumors (prostate cancer, renal clear-cell carcinoma, and bladder cancer [BC]). Initial studies evaluating the role of 18F-FDG-PET in kidney and bladder malignancies showed disappointingly low sensitivity. The main reason is that FDG is mainly excreted through the urinary system, thereby masking the FDG uptake of primary renal and BCs. Many researchers are trying to improve the sensitivity and specificity of PET/CT in urological malignancies through a variety of techniques, including bladder irrigation and delayed imaging. Recent studies using PET/CT instead of PET and some improved protocol techniques have shown better sensitivity and specificity, and PET/CT now appears to be more useful in the staging and follow-up of urinary malignancies than originally reported.

References

  1. 1.
    Apolo AB, Riches J, Schoder H, Akin O, Trout A, Milowsky MI, Bajorin DF (2010) Clinical value of fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in bladder cancer. J Clin Oncol 28(25):3973–3978PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Avery R, Kuo PH (2013) 18F sodium fluoride PET/CT detects osseous metastases from breast cancer missed on FDG PET/CT with marrow rebound. Clin Nucl Med 38(9):746–748PubMedCrossRefGoogle Scholar
  3. 3.
    Bouchelouche K (2012) PET/CT and MRI in bladder cancer. J Cancer Sci Ther s14(1):7692–7709PubMedGoogle Scholar
  4. 4.
    Caldarella C, Muoio B, Isgro MA, Porfiri E, Treglia G, Giovanella L (2014) The role of fluorine-18-fluorodeoxyglucose positron emission tomography in evaluating the response to tyrosine-kinase inhibitors in patients with metastatic primary renal cell carcinoma. Radiol Oncol 48(3):219–227PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Ferda J, Ferdova E, Hora M, Hes O, Finek J, Topolcan O, Kreuzberg B (2013) 18F-FDG-PET/CT in potentially advanced renal cell carcinoma: a role in treatment decisions and prognosis estimation. Anticancer Res 33(6):2665–2672PubMedGoogle Scholar
  6. 6.
    Garcia JR, Soler M, Blanch MA, Ramirez I, Riera E, Lozano P, Perez X, Delgado E, Carrio I, Lomena F (2009) [PET/CT with (11)C-choline and (18)F-FDG in patients with elevated PSA after radical treatment of a prostate cancer]. Rev Esp Med Nucl 28(3):95–100Google Scholar
  7. 7.
    Hillner BE, Siegel BA, Shields AF, Liu D, Gareen IF, Hunt E, Coleman RE (2008) Relationship between cancer type and impact of PET and PET/CT on intended management: findings of the national oncologic PET registry. J Nucl Med 49(12):1928–1935PubMedCrossRefGoogle Scholar
  8. 8.
    Sahni VA, Silverman SG (2014) Imaging management of incidentally detected small renal masses. Semin Intervent Radiol 31(1):9–19PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Jadvar H, Quan V, Henderson RW, Conti PS (2008) [F-18]-Fluorodeoxyglucose PET and PET-CT in diagnostic imaging evaluation of locally recurrent and metastatic bladder transitional cell carcinoma. Int J Clin Oncol 13(1):42–47PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Lu YY, Chen JH, Liang JA, Wang HY, Lin CC, Lin WY, Kao CH (2012) Clinical value of FDG PET or PET/CT in urinary bladder cancer: a systemic review and meta-analysis. Eur J Radiol 81(9):2411–2416PubMedCrossRefGoogle Scholar
  11. 11.
    Jadvar H, Ye W, Groshen S, Cibtut PS (2008) [F-18]-fluorodeoxyglucose PET-CT of the normal prostate gland. Ann Nucl Med 22:787–793PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Minamimoto R, Uemura H, Sano F, Terao H, Nagashima Y, Yamanaka S, Shizukuishi K, Tateishi U, Kubota Y, Inoue T (2011) The potential of FDG-PET/CT for detecting prostate cancer in patients with an elevated serum PSA level. Ann Nucl Med 25(1):21–27PubMedCrossRefGoogle Scholar
  13. 13.
    Minamimoto R, Uemura H, Sano F, Terao H, Nagashima Y, Yamanaka S, Shizukuishi K, Tateishi U, Kubota Y, Inoue T (2011) The potential of FDG-PET/CT for detecting prostate cancer in patients with an elevated serum PSA level. Ann Nucl Med 25(1):21–27PubMedCrossRefGoogle Scholar
  14. 14.
    Minamimoto R, Senda M, Jinnouchi S, Terauchi T, Yoshida T, Murano T, Fukuda H, Iinuma T, Uno K, Nishizawa S, Tsukamoto E, Iwata H, Inoue T, Oguchi K, Nakashima R, Inoue T (2013) The current status of an FDG-PET cancer screening program in Japan, based on a 4-year (2006-2009) nationwide survey. Ann Nucl Med 27(1):46–57PubMedCrossRefGoogle Scholar
  15. 15.
    Tiwari BP, Jangra S, Nair N, Tongaonkar HB, Basu S (2010) Complimentary role of FDG-PET imaging and skeletal scintigraphy in the evaluation of patients of prostate carcinoma. Indian J Cancer 47(4):385–390PubMedCrossRefGoogle Scholar
  16. 16.
    Yu EY, Muzi M, Hackenbracht JA, Rezvani BB, Link JM, Montgomery RB, Higano CS, Eary JF, Mankoff DA (2011) C11-acetate and F-18 FDG PET for men with prostate cancer bone metastases: relative findings and response to therapy. Clin Nucl Med 36(3):192–198PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Damle NA, Bal C, Bandopadhyaya GP, Kumar L, Kumar P, Malhotra A, Lata S (2013) The role of 18F-fluoride PET-CT in the detection of bone metastases in patients with breast, lung and prostate carcinoma: a comparison with FDG PET/CT and 99mTc-MDP bone scan. Jpn J Radiol 31(4):262–269PubMedCrossRefGoogle Scholar
  18. 18.
    Wang N, Jiang P, Lu Y (2014) Is fluorine-18 fluorodeoxyglucose positron emission tomography useful for detecting bladder lesions? A meta-analysis of the literature. Urol Int 92(2):143–149PubMedCrossRefGoogle Scholar
  19. 19.
    Wettersten HI, Aboud OA, Lara PJ, Weiss RH (2017) Metabolic reprogramming in clear cell renal cell carcinoma. Nat Rev Nephrol 13(7):410–419PubMedCrossRefGoogle Scholar
  20. 20.
    Jadvar H, Desai B, Ji L, Conti PS, Dorff TB, Groshen SG, Pinski JK, Quinn DI (2013) Baseline 18F-FDG PET/CT parameters as imaging biomarkers of overall survival in castrate-resistant metastatic prostate cancer. J Nucl Med 54(8):1195–1201PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. and Shanghai Jiao Tong University Press 2019

Authors and Affiliations

  • Xiang Zhou
    • 1
  • Gang Huang
    • 2
  1. 1.Department of Nuclear MedicineRenJi Hospital, School of Medicine, Shanghai JiaoTong UniversityShanghaiP. R. China
  2. 2.Shanghai Key Laboratory of Molecular ImagingShanghai University of Medicine and Health SciencesShanghaiP. R. China

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