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The Diagnostic Value of FDG-PET/CT for Urachal Cancer.

Authors
  • Stokkel, Laura E1
  • Stokkel, Marcel P M2
  • Donswijk, Maarten L2
  • Lahaye, Max J3
  • Bekers, Elise M4
  • van Rhijn, Bas W G5
  • Mertens, Laura S6
  • 1 Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. , (Netherlands)
  • 2 Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands. , (Netherlands)
  • 3 Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. , (Netherlands)
  • 4 Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. , (Netherlands)
  • 5 Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany. , (Germany)
  • 6 Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. Electronic address: [email protected] , (Netherlands)
Type
Published Article
Journal
Clinical Genitourinary Cancer
Publisher
Elsevier
Publication Date
Oct 01, 2021
Volume
19
Issue
5
Pages
373–380
Identifiers
DOI: 10.1016/j.clgc.2021.03.002
PMID: 33858788
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Urachal carcinoma (UrC) is a rare malignancy that often presents at an advanced stage with metastases in up to a quarter of patients. There is no consensus on the optimal form of staging for patients with UrC. In the present study, we evaluated the diagnostic value of 18F-fluorodeoxyglucose-positron emitted tomography/computed tomography (FDG-PET/CT) for UrC. We evaluated 40 consecutive patients who were staged for urachal cancer between 2010 and 2020. They underwent a total of 62 FDG-PET/CTs (40 for primary staging, and 22 during follow-up), which were compared with standard-of-care contrast-enhanced CT (CECT). The metabolic detection of primary tumors, lymph node metastases (LNMs), peritoneal metastases (PMs), distant metastases (DMs), and local recurrence by FDG-PET/CT was evaluated. Sensitivity and specificity were calculated compared with CECT. Histopathology or follow-up imaging was the reference standard. Of all 40 patients, 33 patients (83%) had urachal adenocarcinoma-26 (65%) with a mucinous component and 7 (17%) with invasive urothelial carcinoma. All local UrC tumors could be visualized on CT, and 80% showed increased FDG uptake. At initial staging, FDG-PET/CT detected FDG-avid LNMs, PMs, and DMs in 50%, 17%, and 25% of patients, respectively. These metastases were also visualized on CECT. During follow up, FDG-PET/CT revealed FDG-avid local recurrences that were not seen on CT in two out of eight patients (25%). The present study demonstrates that most UrC can be visualized on FDG-PET/CT. At initial diagnosis, FDG-PET/CT does not seem to yield additional information compared with CECT; however, FDG-PET/CT may be helpful during follow-up. This is a small study, and the findings should be corroborated with larger series. Copyright © 2021 Elsevier Inc. All rights reserved.

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