FDG-PET/CT for Assessing the Response to Neoadjuvant Chemotherapy in Bladder Cancer Patients

Ayman Soubra; Mehmet Gencturk; Jerry W Froelich; Priya Balaji; Shilpa Gupta; Gautam Jha; Badrinath R Konety

doi:10.1016/j.clgc.2018.05.008

FDG-PET/CT for Assessing the Response to Neoadjuvant Chemotherapy in Bladder Cancer Patients

Ayman Soubra, Mehmet Gencturk, Jerry W Froelich, Priya Balaji, Shilpa Gupta, Gautam Jha, Badrinath R Konety

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Abstract

The purpose of this study was to assess the accuracy of ¹⁸F-fluorodeoxyglucose with positron emission tomography and computed tomography (FDG-PET/CT) scans in measuring the response to neoadjuvant chemotherapy (NAC) in patients with muscle invasive bladder cancer. FDG-PET/CT had 78.5% sensitivity (95.6% specificity) in identifying complete pathologic response and 83% sensitivity (94% specificity) for the detection of chemosensitive tumors. FDG-PET/CT can help determine the response of primary tumor to NAC in patients with muscle-invasive bladder cancer and thus can more accurately predict prognosis. Purpose: To determine the accuracy of ¹⁸F-fluorodeoxyglucose with positron emission tomography and computed tomography (FDG-PET/CT) scans in assessing the response to neoadjuvant chemotherapy (NAC) in patients with bladder cancer scheduled to undergo radical cystectomy (RC). Patients and Methods: All patients treated at our center for muscle-invasive bladder cancer (MIBC) were counseled and offered NAC before RC. FDG-PET/CT scans were performed before the initiation of chemotherapy and after completion of the regimen. Patients with disease with complete response to NAC were those who had (pT0) or residual carcinoma-in-situ (pTis) on final pathology. Those who were downstaged from MIBC to non-MIBC were considered to have a chemosensitive tumor. We used percentage reduction in standardized maximum uptake value (SUV_max) from PET/CT scans as our measure to correlate with the final pathology after cystectomy. Results: Thirty-seven patients with MIBC who underwent NAC followed by RC were included in the final analysis. FDG-PET/CT had 75% sensitivity (89.66% specificity) in identifying those with complete pathologic response with a 100% change in SUV_max, and 83% sensitivity (94% specificity) for the detection of chemosensitive tumors. Conclusion: FDG-PET/CT can help determine the response of primary tumor to NAC in patients with MIBC and thus can more accurately predict the prognosis of the patients, or potentially the appropriate time for cystectomy.

Original language	English (US)
Pages (from-to)	360-364
Number of pages	5
Journal	Clinical Genitourinary Cancer
Volume	16
Issue number	5
DOIs	https://doi.org/10.1016/j.clgc.2018.05.008
State	Published - Oct 2018

Keywords

Clinical response
Pathologic stage
Urinary bladder neoplasms
Urothelial carcinoma

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title = "FDG-PET/CT for Assessing the Response to Neoadjuvant Chemotherapy in Bladder Cancer Patients",

abstract = "The purpose of this study was to assess the accuracy of 18F-fluorodeoxyglucose with positron emission tomography and computed tomography (FDG-PET/CT) scans in measuring the response to neoadjuvant chemotherapy (NAC) in patients with muscle invasive bladder cancer. FDG-PET/CT had 78.5% sensitivity (95.6% specificity) in identifying complete pathologic response and 83% sensitivity (94% specificity) for the detection of chemosensitive tumors. FDG-PET/CT can help determine the response of primary tumor to NAC in patients with muscle-invasive bladder cancer and thus can more accurately predict prognosis. Purpose: To determine the accuracy of 18F-fluorodeoxyglucose with positron emission tomography and computed tomography (FDG-PET/CT) scans in assessing the response to neoadjuvant chemotherapy (NAC) in patients with bladder cancer scheduled to undergo radical cystectomy (RC). Patients and Methods: All patients treated at our center for muscle-invasive bladder cancer (MIBC) were counseled and offered NAC before RC. FDG-PET/CT scans were performed before the initiation of chemotherapy and after completion of the regimen. Patients with disease with complete response to NAC were those who had (pT0) or residual carcinoma-in-situ (pTis) on final pathology. Those who were downstaged from MIBC to non-MIBC were considered to have a chemosensitive tumor. We used percentage reduction in standardized maximum uptake value (SUVmax) from PET/CT scans as our measure to correlate with the final pathology after cystectomy. Results: Thirty-seven patients with MIBC who underwent NAC followed by RC were included in the final analysis. FDG-PET/CT had 75% sensitivity (89.66% specificity) in identifying those with complete pathologic response with a 100% change in SUVmax, and 83% sensitivity (94% specificity) for the detection of chemosensitive tumors. Conclusion: FDG-PET/CT can help determine the response of primary tumor to NAC in patients with MIBC and thus can more accurately predict the prognosis of the patients, or potentially the appropriate time for cystectomy.",

keywords = "Clinical response, Pathologic stage, Urinary bladder neoplasms, Urothelial carcinoma",

author = "Ayman Soubra and Mehmet Gencturk and Froelich, {Jerry W} and Priya Balaji and Shilpa Gupta and Gautam Jha and Konety, {Badrinath R}",

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AU - Jha, Gautam

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AB - The purpose of this study was to assess the accuracy of 18F-fluorodeoxyglucose with positron emission tomography and computed tomography (FDG-PET/CT) scans in measuring the response to neoadjuvant chemotherapy (NAC) in patients with muscle invasive bladder cancer. FDG-PET/CT had 78.5% sensitivity (95.6% specificity) in identifying complete pathologic response and 83% sensitivity (94% specificity) for the detection of chemosensitive tumors. FDG-PET/CT can help determine the response of primary tumor to NAC in patients with muscle-invasive bladder cancer and thus can more accurately predict prognosis. Purpose: To determine the accuracy of 18F-fluorodeoxyglucose with positron emission tomography and computed tomography (FDG-PET/CT) scans in assessing the response to neoadjuvant chemotherapy (NAC) in patients with bladder cancer scheduled to undergo radical cystectomy (RC). Patients and Methods: All patients treated at our center for muscle-invasive bladder cancer (MIBC) were counseled and offered NAC before RC. FDG-PET/CT scans were performed before the initiation of chemotherapy and after completion of the regimen. Patients with disease with complete response to NAC were those who had (pT0) or residual carcinoma-in-situ (pTis) on final pathology. Those who were downstaged from MIBC to non-MIBC were considered to have a chemosensitive tumor. We used percentage reduction in standardized maximum uptake value (SUVmax) from PET/CT scans as our measure to correlate with the final pathology after cystectomy. Results: Thirty-seven patients with MIBC who underwent NAC followed by RC were included in the final analysis. FDG-PET/CT had 75% sensitivity (89.66% specificity) in identifying those with complete pathologic response with a 100% change in SUVmax, and 83% sensitivity (94% specificity) for the detection of chemosensitive tumors. Conclusion: FDG-PET/CT can help determine the response of primary tumor to NAC in patients with MIBC and thus can more accurately predict the prognosis of the patients, or potentially the appropriate time for cystectomy.

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FDG-PET/CT for Assessing the Response to Neoadjuvant Chemotherapy in Bladder Cancer Patients

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