J Nucl Med 2003 Mar;44(3):353-8
Evaluation of 18F-FDG PET with bladder irrigation in patients with uterine
and ovarian tumors.
Koyama K, Okamura T, Kawabe J, Ozawa N, Torii K, Umesaki N, Miyama M, Ochi H,
Yamada R.
The purpose of this study was to evaluate PET using (18)F-FDG for gynecologic
lesions with continuous bladder irrigation to eliminate artifacts from the
(18)F-FDG activity in the bladder. METHODS: Forty-one patients were studied.
They had 23 cervical uterine lesions (15 cases of cancer, 5 recurrences, 3
nonrecurrences); 8 cases of uterine corpus cancer, including 2 recurrences; and
10 ovarian masses (6 malignant, 4 nonmalignant). All cases of cancer were
histologically proven; however, 2 cases of nonrecurrent uterine cervical
carcinomas were diagnosed by clinical course. Continuous bladder irrigation was
performed 35-55 min after intravenous administration of 185-370 MBq (18)F-FDG,
and an emission scan was obtained 40-55 min after intravenous administration.
Standardized uptake value (SUV) was used to estimate the degree of (18)F-FDG
uptake quantitatively. RESULTS: After bladder irrigation, the (18)F-FDG activity
in the urinary tract was eliminated in 33 patients, so that detection of tumor
(18)F-FDG accumulation was easy. Two patients showed residual activity in the
urinary bladder, and 6 patients showed activity in the ureter. An artifact was
seen in 1 patient with residual activity in the urinary bladder caused by
insufficient irrigation. However, these residual activities had no influence on
detecting (18)F-FDG accumulation in tumor. The mean (+/-SD) of SUVs of malignant
lesions was 6.04 +/- 3.22, that of nonmalignant lesions was 1.71 +/- 1.12, and
the difference was significant (P = 0.0002). SUVs of all malignant lesions were
greater than 2.0, and SUVs of all nonmalignant lesions, except the 1 case of
ovarian fibroma, were less than 2.0. CONCLUSION: (18)F-FDG PET with continuous
bladder irrigation is useful for eliminating (18)F-FDG activity in the bladder
and for differentiating between malignant and nonmalignant uterine or ovarian
masses.
