In a study that included 41 patients with suspected recurrent bladder cancer after primary treatment that underwent FDG-PET/CT, authors found that FDG-PET/CT had a sensitivity of 87% and specificity of 94% for recurrent/metastatic bladder cancer following treatment [55]. In this study, metastatic disease was found in abdominal and pelvic lymph nodes, including suprarenal lymph nodes; pulmonary and osseous metastatic disease was also identified. Perhaps more importantly, the results of the FDG-PET/CT changed the treatment decision in 40% of patients and had prognostic value in determining overall survival and progression-free survival. In another study of the National Oncologic PET Registry, authors found that FDG-PET/CT changed management in approximately 35% of patients and had a large impact on chemotherapy monitoring [56]. In addition, there is Post-Treatment Surveillance of Bladder Cancer increasing evidence that FDG-PET/CT can be used to assess for treatment response after neoadjuvant or induction chemotherapy [57-59]. Although not widely available, there is increasing interest in 11C-choline-PET. In a study of 27 patients with either MIBC or recurrent NMIBC that failed TURBT and intravesical therapy, the presence of residual bladder cancer was detected in 84% (21 of 25) of patients with CT and 96% (24 of 25) of patients with 11C-choline PET, and lymph node involvement was identified correctly in 50% (4 of 8) of patients with CT and 62% (5 of 8) of patients with PET [60]. Fluoroscopy Abdomen Loopogram Abdominal radiography can be useful in the early postoperative setting to evaluate for ureteral stent location and to evaluate patients with abdominal distention and postoperative ileus.
Post Treatment Surveillance of Bladder Cancer. In a study that included 41 patients with suspected recurrent bladder cancer after primary treatment that underwent FDG-PET/CT, authors found that FDG-PET/CT had a sensitivity of 87% and specificity of 94% for recurrent/metastatic bladder cancer following treatment [55]. In this study, metastatic disease was found in abdominal and pelvic lymph nodes, including suprarenal lymph nodes; pulmonary and osseous metastatic disease was also identified. Perhaps more importantly, the results of the FDG-PET/CT changed the treatment decision in 40% of patients and had prognostic value in determining overall survival and progression-free survival. In another study of the National Oncologic PET Registry, authors found that FDG-PET/CT changed management in approximately 35% of patients and had a large impact on chemotherapy monitoring [56]. In addition, there is Post-Treatment Surveillance of Bladder Cancer increasing evidence that FDG-PET/CT can be used to assess for treatment response after neoadjuvant or induction chemotherapy [57-59]. Although not widely available, there is increasing interest in 11C-choline-PET. In a study of 27 patients with either MIBC or recurrent NMIBC that failed TURBT and intravesical therapy, the presence of residual bladder cancer was detected in 84% (21 of 25) of patients with CT and 96% (24 of 25) of patients with 11C-choline PET, and lymph node involvement was identified correctly in 50% (4 of 8) of patients with CT and 62% (5 of 8) of patients with PET [60]. Fluoroscopy Abdomen Loopogram Abdominal radiography can be useful in the early postoperative setting to evaluate for ureteral stent location and to evaluate patients with abdominal distention and postoperative ileus.