Prospective evaluation of MRI, 11C-acetate PET/CT and contrast-enhanced CT for staging of bladder cancer Journal Article


Authors: Vargas, H. A.; Akin, O.; Schoder, H.; Olgac, S.; Dalbagni, G.; Hricak, H.; Bochner, B. H.
Article Title: Prospective evaluation of MRI, 11C-acetate PET/CT and contrast-enhanced CT for staging of bladder cancer
Abstract: Purpose: To prospectively evaluate the diagnostic performance of magnetic resonance imaging (MRI), 11C-acetate positron emission tomography/computed tomography (PET/CT) and contrast-enhanced CT for bladder cancer staging, using whole-mount pathologic review of radical cystectomy and pelvic lymph node specimens as the reference standard. Materials and methods: The institutional review board approved this prospective study, which was compliant with the Health Insurance Portability and Accountability Act. Written informed consent was obtained from 16 patients with histologically confirmed bladder cancer who underwent MRI, 11C-acetate PET/CT and contrast-enhanced CT before radical cystectomy and pelvic lymph node dissection. Before imaging 4/16 patients had received intravesical Bacillus Calmette-Guérin treatment, 6 had received systemic chemotherapy, 3 had received both and 3 had received neither. Measures of diagnostic performance including accuracy, sensitivity and specificity were estimated separately for each imaging modality. Results: MRI correctly staged 56% of patients (9/16), overstaged 38% (6/16) and understaged 6% (1/16). CT correctly staged 50% of patients (8/16), overstaged 44% (7/16) and understaged 6% (1/16). In 9 patients, 11C-acetate PET/CT showed uptake within the bladder wall; the uptake was true-positive in 7 patients and false-positive in 2 patients. Of the remaining 7 patients, 5 had true-negative and 2 had false-negative PET/CT results for cancer in the bladder wall. For all modalities, staging accuracy was reduced in patients with a history of prior intravesical and/or systemic chemotherapy. Conclusion: In staging bladder cancer, MRI, 11C-acetate PET/CT and CT displayed similar levels of accuracy. For all modalities, a history of intravesical and/or systemic chemotherapy affected staging accuracy. © 2012 Elsevier Ireland Ltd© 2011 Elsevier Ireland Ltd. All rights reserved.
Keywords: adult; cancer chemotherapy; clinical article; aged; histopathology; review; systemic therapy; cancer staging; nuclear magnetic resonance imaging; lymph node metastasis; pelvis lymph node; diagnostic accuracy; prospective study; sensitivity and specificity; bcg vaccine; bladder cancer; contrast enhancement; computer assisted emission tomography; cystectomy; pet; acetic acid c 11; ct; mri; pet/ct; bladder wall; acetate; carbon-11
Journal Title: European Journal of Radiology
Volume: 81
Issue: 12
ISSN: 0720-048X
Publisher: Elsevier Ireland Ltd.  
Date Published: 2012-12-01
Start Page: 4131
End Page: 4137
Language: English
DOI: 10.1016/j.ejrad.2012.06.010
PROVIDER: scopus
PUBMED: 22858427
DOI/URL:
Notes: --- - "Export Date: 2 January 2013" - "CODEN: EJRAD" - "Source: Scopus"
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MSK Authors
  1. Guido Dalbagni
    253 Dalbagni
  2. Semra Olgac
    98 Olgac
  3. Heiko Schoder
    289 Schoder
  4. Hedvig Hricak
    333 Hricak
  5. Bernard Bochner
    327 Bochner
  6. Oguz Akin
    179 Akin