Zhou, Xiang; Lu, Zehua; Zhang, Ruixue; Zhang, Ruiyun; Huang, Gang; Shi, Kuangyu; Chen, Haige; Liu, Jianjun (2024). The Value of Dual Time Point 18F-FDG PET/CT Imaging in Differentiating Lymph Node Metastasis From Reactive Hyperplasia in Bladder Urothelial Carcinoma. Academic radiology, 31(8), pp. 3272-3281. Elsevier 10.1016/j.acra.2024.02.014
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RATIONALE AND OBJECTIVES
This study explored the clinical value of dual time-point 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) imaging for differentiating lymph node metastasis from lymph nodes with reactive hyperplasia.
METHODS
250 lymph nodes from 153 bladder cancer patients who underwent 18F-FDG PET/computed tomography (CT) delayed diuretic imaging were analyzed. The maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume (MTV), and related delay indices before and after PET delayed imaging were obtained. Relationships with outcomes were analyzed using nonparametric and multivariate analyses. Receiver operating characteristic curves and nomograms were drawn to predict lymph node metastasis.
RESULTS
Delayed PET/CT imaging showed better detection of hyperplasia and metastatic lymph nodes. Delayed imaging with a cutoff SUVmax of 2.0 or 2.5 increased the detection rate of metastatic lymph nodes by 4.1%, and 6.9%, respectively. Delayed imaging often showed speckle-like radioactive foci in lymph nodes with reactive hyperplasia and increased FDG uptake throughout the nodes in metastatic lymph nodes. The lymph node short-axis diameter, SUVmean, and delayed index of MTV (DIMTV) were independent predictors for differentiating metastatic lymph nodes from reactive hyperplasia, and their combination showed better differentiation performance than the individual predictors. In high-risk patients, the probability of lymph node metastasis was as high as 97.6%.
CONCLUSION
Dual time-point imaging can detect more metastatic lymph nodes. Some lymph nodes with hyperplasia show speckle-like radioactive foci on delayed imaging. The lymph node short-axis diameter, SUVmean, and DIMTV are three important parameters for predicting lymph node metastasis.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine |
UniBE Contributor: |
Shi, Kuangyu |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1076-6332 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
04 Mar 2024 14:05 |
Last Modified: |
01 Sep 2024 00:12 |
Publisher DOI: |
10.1016/j.acra.2024.02.014 |
PubMed ID: |
38431484 |
Uncontrolled Keywords: |
Bladder cancer Fluorodeoxyglucose F18 Hyperplasia Lymphatic metastasis Positron Emission Tomography Computed Tomography |
BORIS DOI: |
10.48350/193738 |
URI: |
https://boris.unibe.ch/id/eprint/193738 |
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