PD4-07 PREOPERATIVE FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY ON THE DIAGNOSIS IN UPPER URINARY TRACT CANCER

INTRODUCTION AND OBJECTIVES: Fluorodeoxygulcose positron emission tomography/computed tomography (FDG-PET/CT) is becoming useful for diagnosis, staging and prognosis in many cancers. In contrary, the use in urological oncology has been slower to develop because the radiotracer is excreted into the urine. Then, to assess the ability of preoperative FDG-PET/CT to detect upper urinary tract cancers (UUTC), compared with pathological examinations of tissues obtained by ureteroscopic biopsy or split cytologic analysis of urines obtained following retrograde pyelography. METHODS: Clinicopathological records of patients who were examined by FDG-PET/CT were retrospectively reviewed. Sixty-four patients (66 lesions) with clinically suspected UUTC, who were diagnosed by ureteroscopy or nephroureterectomy or partial ureterectomy at our institution from September 2010 to September 2014, were included. The patient cohort consisted of 51 men and 13 women, with a median age of 73 (range 54e92) years. RESULTS: 66 lesions were histologically diagnosed as 59 urothelial carcinomas and 1 clear cell carcinoma and 6 benign lesions. Only 22% of 58 lesions with UUTC had positive voided urine cytology and 45% of 47 lesions had positive split urine cytology. In addition, only 53 % of 15 lesions with UUTC had positive endoscopic biopsy. However, 83% of 60 lesions with UUTC had positive FDG-PET/CT examination. The positive predictive value was 93%. The sensitivities of PET/CT and tumor stage or tumor grade. Mean SUVmax was 3.0 and 10.0 in benign lesions and UUTC, respectively. The difference was statistically significant (p1⁄40.027). The ROC analysis showed that a SUVmax cut-off value to discriminate UUTC was 5.6. The sensitivity and the specificity were 76% and 80%, respectively. An area under the curve was 0.800 (Fig). CONCLUSIONS: FDG-PET/CT was effective to detect UUTC. Furthermore, SUVmax had a role of supplementary index. FDG-PET/ CT may be able to replace of endoscopic biopsy depending on the patients. Source of Funding: none