Up and down staging of TCC using 18F-FDG PET/CT scan

ObjectiveThe purpose of this study was to investigate the ability of PET/CT to restage urinary bladder transitional cell carcinoma (TCC) whether up or down after initial staging by histopathology and other imaging modalities.Patients and methodsDuring three year duration 27 patients with urinary bladder TCC were prospectively evaluated. They were previously diagnosed by histopathology after biopsy and had prior imaging for initial staging. All patients underwent PET/CT examinations following a preset protocol. The images obtained were reconstructed using dedicated software and workstations. Results of PET/CT examinations were confirmed by histopathology.ResultsPrior imaging and PET/CT findings were matched in 17 patients (63%) with no changes regarding their initial TNM stages and differed in 10 patients (37%). Six patients (22.2%) showed new sites of distant metastasis and unchanged initial stages. Two patients (7.4%) were up staged and 2 patients (7.4%) were down staged for whom the plan of clinical management was justified.Conclusion18F-FDG PET/CT can up and down stage TCC and can detect new sites of nodal or distant metastasis leading to optimal therapy planning.