Munenobu Nogami MD, PhD, Presenter: Nothing to Disclose

Hitomi Iwasa MD, Abstract Co-Author: Nothing to Disclose

Shino Kohsaki MD, Abstract Co-Author: Nothing to Disclose

Taiji Tamura, Abstract Co-Author: Nothing to Disclose

Michiko Tadokoro MD, Abstract Co-Author: Nothing to Disclose

Kei Kubota MD, PhD, Abstract Co-Author: Nothing to Disclose

Kazuo Morio, Abstract Co-Author: Nothing to Disclose

Naoki Akagi, Abstract Co-Author: Nothing to Disclose

Akihito Nishioka MD, PhD, Abstract Co-Author: Nothing to Disclose

By using diuretic, evaluation of urothelial carcinoma is feasible on FDG PET/CT. The purpose was to determine the association between glucose metabolism, restricted diffusion and pathological characteristics of urothelial carcinoma by comparison of FDG PET/CT after diuretic (diuretic PET/CT) and diffusion weighted (DWI) MR imaging. 

Twenty-two consecutive patients with pathologically confirmed urothelial carcinoma (bladder cancer, n=8; ureteral cancer, n=6; and renal pelvis cancer, n=8) underwent diuretic PET/CT and DWI MRI within one week without any therapy and/ or intervention. Diuretic PET/CT was performed 180 min after administration of FDG and 60 min after furosemide injection, followed by a contrast-enhanced CT. DWI MRI was acquired at 3.0T with b-values of 0 and 1000 sec/mm2. Maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin) were measured by placing a region of interest on diuretic PET/CT and DWI MRI, respectively. Pathological results including tumor depth, lymphatic and venous permeation were acquired from all the subjects by operations and biopsies. To determine the relationship between glucose metabolism and restricted diffusion of the tumors, SUVmax and ADCmin were statistically compared by the Spearman’s rank correlation coefficient. To evaluate the correlation between pathological status and glucose metabolism and/ or restricted diffusion, SUVmax and ADCmin were statistically compared with pathological characteristics by the Mann-Whitney test.

The histopathological results showed 16 invasive and 6 non-invasive urothelial carcinomas. Significant inverse correlation was found between SUVmax (13.5 ± 9.8) and ADCmin (1.09 ± 0.51 × 10-3 mm2/s) (r=-0.51, p<0.05). There was no significant correlation of pathological findings with SUVmax and/or ADCmin.

In this preliminary study, there was significant correlation between SUVmax and ADCmin, suggesting relationship between glucose metabolism and restricted diffusion of the urothelial carcinoma similar to the other cancers reported by the literatures. Pathological characteristics of the urothelial carcinoma may be determined by the other factors of the tumor.

Diuretic FDG PET/CT yields evaluation of glucose metabolism of urothelial carcinoma and may have incremental role of quantitative evaluation for the patients with urothelial carcinoma.

Nogami, M, Iwasa, H, Kohsaki, S, Tamura, T, Tadokoro, M, Kubota, K, Morio, K, Akagi, N, Nishioka, A, Diuretic FDG PET/CT and Diffusion Weighted MR Imaging for Urothelial Carcinoma: Comparison of SUV, ADC and Pathological Characteristics.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014937.html