JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (10): 1336-1343.doi: 10.3969/j.issn.1674-8115.2021.10.011

• Clinical research • Previous Articles     Next Articles

Prognostic value of delayed diuretic 18F-FDG PET/CT before radical cystectomy for bladder cancer

Kun ZHOU1(), Yu-mei CHEN1, Jian-jun LIU1, Gang HUANG2()   

  1. 1.Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    2.Shanghai Key Laboratory for Molecular Imaging, Shanghai 201318, China
  • Online:2021-10-28 Published:2021-09-03
  • Contact: Gang HUANG;

Abstract: Objective

·To evaluate the prognostic value of preoperative delayed diuretic 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging in patients with bladder cancer.


·The clinical data and preoperative delayed diuretic 18F-FDG PET/CT images of 104 bladder cancer patients who received radical cystectomy (RC) from 2016 to 2018 at Renji Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The diagnostic ability and optimal boundary values of maximum standardized uptake value (SUVmax), tumor metabolic volume (MTV) and total lesion glycolysis (TLG) were obtained by receiver operating characteristic curve (ROC) analysis. Patients were divided into high SUVmax group (n=53) and low SUVmax group (n=51), high MTV group (n=52)and low MTV group (n=52), high TLG group (n=67)and low TLG group (n=37). The correlation between PET/CT metabolic parameters and clinical data was analyzed by chi-square test. Survival curves were drawn by Kaplan-Meier method and tested by Log-rank method. The prognostic value of metabolic parameters was evaluated by Cox regression model.


·MTV (P=0.000) and TLG (P=0.000) had diagnostic abilities for postoperative recurrence of bladder cancer. Preoperative treatment (P=0.033) and T stage of tumor (P=0.035) were correlated with MTV, while neutrophil-lymphocyte ratio (NLR) (P=0.026), hemoglobin (P=0.004), albumin(P=0.021), preoperative treatment (P=0.015) and T stage (P=0.015) were related to TLG. Multivariate Cox regression analysis showed that lymph node metastasis (HR=2.433, P=0.016) and TLG (HR=4.499, P=0.000) were independent prognostic factors of progression-free survival (PFS), while preoperative treatment (HR=0.220, P=0.014) and TLG (HR=7.107,P=0.013) were independent predictors of overall survival (OS).


·Delayed diuretic 18F-FDG PET/CT before RC can predict the postoperative survival.

Key words: bladder cancer, PET/CT, delayed imaging, metabolic parameters, prognostic prediction

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