Surgery Department, Clemenceau Medical Center, Dubai, United Arab Emirates.
Radiation Oncology Department, King Hussein Cancer Center, Amman, Jordan.
J Egypt Natl Canc Inst. 2023 Jul 17;35(1):21. doi: 10.1186/s43046-023-00180-5.
The purpose of this study was to assess the usefulness of fluorodeoxyglucose positron emission tomography (F-FDG PET)-computed tomography (CT) scan for staging urinary bladder cancer. The study also sought to determine the effect of F-FDG PET/CT on management decisions and its implications for patient care.
A total of 133 patients with bladder cancer who had both conventional imaging and F-FDG PET/CT for initial staging were identified. All F-FDG-PET/CT findings were classified as true positive, true negative, false positive, or false negative based on their potential to impact the intent of treatment. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated using the standard definition. Furthermore, the rate of change in therapy intent was determined for the entire sample and for subgroups with non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) patients.
The overall concordance rate between PET/CT and conventional imaging was around 54%. On conventional images, 18% of patients had localized disease, which was upstaged in 6.8% of cases using F-FDG PET/CT. Pelvic lymph node involvement was detected in 18.8% of cases using conventional imaging, which was downstaged to localized disease in 4.5% of cases using F-FDG PET/CT. While 63.2% of patients had systemic disease on a CT scan, 24.7% of cases were downstaged using PET/CT. Overall, the rate of change in therapy intent was 26.3% for the entire sample, 24.5% for NMIBC subgroup, and 27.3% for MIBC patients.
The study found that F-FDG PET/CT is an effective and accurate tool for staging bladder cancer in newly diagnosed patients. Approximately one quarter of patients had a change in management intent based on F-FDG PET/CT results. The study suggests that PET/CT should be used as a standard for newly diagnosed patients, but more research is needed to confirm this.
本研究旨在评估氟代脱氧葡萄糖正电子发射断层扫描（F-FDG PET）-计算机断层扫描（CT）在膀胱癌分期中的作用。该研究还旨在确定 F-FDG PET/CT 对管理决策的影响及其对患者护理的意义。
共确定了 133 例接受常规影像学检查和 F-FDG PET/CT 进行初始分期的膀胱癌患者。所有 F-FDG-PET/CT 结果均根据其对治疗意图的影响潜力分为真阳性、真阴性、假阳性或假阴性。使用标准定义计算灵敏度、特异性、阳性预测值和阴性预测值。此外，还确定了整个样本以及非肌肉浸润性膀胱癌（NMIBC）和肌肉浸润性膀胱癌（MIBC）患者亚组的治疗意图变化率。
PET/CT 与常规影像学的总体一致性率约为 54%。在常规图像上，18%的患者有局限性疾病，其中 6.8%的病例使用 F-FDG PET/CT 进行了分期升级。18.8%的病例在常规图像上检测到盆腔淋巴结受累，其中 4.5%的病例使用 F-FDG PET/CT 进行了分期降级。虽然 63.2%的患者在 CT 扫描上有全身疾病，但 24.7%的病例使用 PET/CT 进行了分期降级。总的来说，整个样本的治疗意图变化率为 26.3%，NMIBC 亚组为 24.5%，MIBC 患者为 27.3%。
本研究发现 F-FDG PET/CT 是一种有效且准确的工具，可用于对新诊断的膀胱癌患者进行分期。约有四分之一的患者根据 F-FDG PET/CT 结果改变了治疗意图。该研究表明，PET/CT 应作为新诊断患者的标准，但还需要更多的研究来证实这一点。
