Editor’s note: Recently, ASCO-GU, the top event in the field of genitourinary cancers, was held in San Francisco, USA. During the meeting, Dr. Antonio Cigliola shared a study on using fluoro-deoxy-glucose positron emission tomography (FDG-PET) vs. CT to predict the prognosis of neoadjuvant treatment for muscle-invasive bladder cancer (MIBC) patients. “Oncology Frontier” invited Dr. Antonio Cigliola to share the experience.
Antonio Cigliola, MD
Medical Oncology Department, IRCCS San Raffaele Hospital
Oncology Frontier:The prognosis of MIBC depends on the stage and grade of the tumor. Among them, what value does FDG-PET have in patient staging?
Dr. Antonio Cigliola:Thank you for the question. FDG-PET could have an important role when we consider the stage of the tumor. In particular one of the most interesting the results of our study, was that in patients with the pre-therapy CT-negative, FDG-PET could have an important role in patients stage; for example, patients with clinical stage three to four, where there is a risk to have lymph node invasion but the CT is negative. While considering the grading, we evaluated the correlation between grading and the response of FDG-PET, but we didn’t have positive results.
Oncology Frontier:What are the predictive outcomes of FDG-PET in MIBC patients with LNI undergoing neoadjuvant therapy?
Dr. Antonio Cigliola:What we know with our results is that FDG-PET has similar accuracy in most pelvic LNI region with CT. But we had the true most important exceptions, the first was a lower accuracy for the presacral lymph of the region, and the second exception is in patients with the variant histologies where the performance of FDG-PET was lower than CT.
Oncology Frontier:How do you think the imaging technology for these patients should be improved so that they can receive precise treatment and achieve a better quality of life?
Dr. Antonio Cigliola:Probably FDG-PET could be useful in patients with the muscle-invasive bladder cancer, not only to evaluate in patients with risk to have pathological LNI and pre-therapy FDG uptake, but also to evaluate the tumor sites and the response to the neoadjuvant treatment. In fact, compare with other techniques, such as CT and MRI，FDG-PET can give an important improvement in evaluating the tumor.
