Efficacy of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in restaging muscle-invasive bladder cancer following radical cystectomy

The aim of the present study was to retrospectively evaluate the contribution and effectiveness of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) scans in the restaging of patients following radical cystectomy due to muscle-invasive bladder carcinoma (MIBC). A total of 51 patients (45 males and six females) who underwent radical cystectomy due to invasive bladder cancer, and had an 18F-FDG-PET/CT scan for restaging between July 2007 and April 2013, were included in the present study. The mean age was 62.3±9.79 years (range, 40-82 years). Patients underwent a six-hour fast prior to scanning, and whole-body PET scanning from the skull base to the upper thighs was performed ~1 h after the intravenous injection of 555 MBq 18F-FDG. Whole-body CT scanning was performed in a cranio-caudal direction. 18F-FDG-PET images were reconstructed using CT data for attenuation correction. Histopathology or clinical follow-up was used to confirm any suspicious recurrent or metastatic lesions. The results for sensitivity, specificity, positive predictive value (PPV), negative predictive value and accuracy of 18F-FDG-PET/CT were 92, 83, 94, 77 and 90%, respectively. In conclusion, 18F-FDG-PET/CT efficiently detects local recurrence and distant metastases with high sensitivity and PPV in the restaging of patients who underwent radical cystectomy due to invasive bladder cancer. This procedure could play an important role in rendering decisions regarding radiotherapy or chemotherapy and post-operative follow-up, and could influence the entire decision-making process.