2203 UTILITY OF FDG-PET/CT IN IDENTIFYING BONE METASTASIS IN PATIENTS WITH BLADDER CANCER

You have accessJournal of UrologyImaging/Radiology: Uroradiology (II)1 Apr 20132203 UTILITY OF FDG-PET/CT IN IDENTIFYING BONE METASTASIS IN PATIENTS WITH BLADDER CANCER Phillip Abbosh, Kenneth Nepple, Aleksandra Klim, Seth Strope, Farrokh Dehdashti, Barry Siegel, Adam Kibel, and Robert Grubb Phillip AbboshPhillip Abbosh St Louis, MO More articles by this author , Kenneth NeppleKenneth Nepple Iowa City, IA More articles by this author , Aleksandra KlimAleksandra Klim St Louis, MO More articles by this author , Seth StropeSeth Strope St Louis, MO More articles by this author , Farrokh DehdashtiFarrokh Dehdashti St Louis, MO More articles by this author , Barry SiegelBarry Siegel St Louis, MO More articles by this author , Adam KibelAdam Kibel Boston, MA More articles by this author , and Robert GrubbRobert Grubb St Louis, MO More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2112AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Identification of bone metastasis in patients with urothelial carcinoma of the bladder currently relies on alkaline phosphatase and bone scintigraphy (BS). 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (PET/CT) has proven useful in detecting soft tissue metastasis. Its role in identifying bone metastasis is unknown. Herein, we compare the utility of PET/CT and BS for detecting osseous metastasis in patients with urothelial carcinoma. METHODS We identified 292 patients with urothelial carcinoma of the bladder at our institution who underwent either BS (N=221), PET/CT (N=117) or both (N=48) between 1 Jan 2004 and 30 Jan 2011. Studies were considered concurrent if they were performed within 90 days of each other. We collected standard demographic, radiologic, and pathologic data on each patient. RESULTS Overall, 49 of 292 patients (17%) in this cohort had bone metastasis diagnosed as a result of one or both imaging tests. The positivity rate for the two methods was similar: 39 of 221 (18%) for BS and 17 of 117 (15%) for PET/CT. Concurrent BS and PET/CT had concordant results regarding the presence or absence of skeletal disease in 29 of 30 patients (97%). The lone discordant patient had PET/CT showing skeletal metastasis but negative BS on the same day. In 7 more patients, BS missed or underestimated the extent of skeletal disease that was identified by other imaging performed within 14 days (3 by PET/CT, 4 by other radiologic studies). No additional lesions were identified by other imaging after PET/CT. BS and PET/CT performed similarly across all stages of disease. The two methods performed similarly in detecting metastasis in recurrent disease after radical cystectomy (12 of 35 [34%] by BS and 5 of 15 [33%] by PET/CT). CONCLUSIONS BS and PET/CT identified a similar proportion of patients with skeletal metastasis, but BS often demonstrates less extensive disease than PET/CT. PET/CT appears to be as effective as BS in detecting osseous metastatic disease in patients with urothelial malignancy with the added benefit of also imaging soft tissue metastases. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e903 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Phillip Abbosh St Louis, MO More articles by this author Kenneth Nepple Iowa City, IA More articles by this author Aleksandra Klim St Louis, MO More articles by this author Seth Strope St Louis, MO More articles by this author Farrokh Dehdashti St Louis, MO More articles by this author Barry Siegel St Louis, MO More articles by this author Adam Kibel Boston, MA More articles by this author Robert Grubb St Louis, MO More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...