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Abdominal Radiology

, Volume 42, Issue 5, pp 1415–1423 | Cite as

18F-FDG PET/CT delayed images with forced diuresis for revaluating abdominopelvic malignancies

  • Hui-Chun Wang
  • Zhi-Min Wang
  • Yu-Bin Wang
  • Xiao-Hong Chen
  • Lan-Lan Cui
Article

Abstract

Purpose

The aim of this retrospective study was to evaluate the role of delayed images after forced diuresis coupled with oral hydration in abdominopelvic 18F-FDG PET/CT.

Materials and methods

Forty-six patients consisting of 17 urological diseases, 9 gynecological tumors, 18 colorectal malignancies, and 2 cancers of unknown primary site were retrospectively analyzed. All patients who presented with indeterminate or equivocal abdominopelvic foci on standard 18F-FDG PET/CT underwent a delayed abdominopelvic imaging after administration of 20 mg furosemide intravenously and extra water intake of 500 mL. PET/CT images before and after furosemide were compared with each other and their findings correlated with pathology or clinical follow-up (>6 months).

Results

On initial PET/CT, the glucose metabolism characters of lesions were disguised by radioactive urine, or some undetermined 18F-FDG accumulating foci near the urinary tract appeared. While postdiuretic PET/CT demonstrated an excellent urinary tracer washout, and hypermetabolic lesions could be clearly detected and precisely localized in all cases. On the other hand, the suspected active foci caused by potential stagnation of excreted 18F-FDG in urinary tract were eliminated. The sensitivity, specificity, and accuracy were 94.4% (34/36), 8/10, 91.3% (42/46), respectively. Furthermore, the additional lesions with surrounding invasion or locoregional metastasis were discovered in 8 of 46 (17.4%) patients only by the delayed images, including 2 gynecological and 6 rectal malignancies.

Conclusion

Detection of abdominopelvic malignancies can be improved using delayed 18F-FDG PET/CT images after a diuretic and oral hydration.

Keywords

Urological lesions Gynecological tumors Rectal cancers 18F-FDG PET/CT Forced diuresis Oral hydration 

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Hui-Chun Wang
    • 1
  • Zhi-Min Wang
    • 2
  • Yu-Bin Wang
    • 1
  • Xiao-Hong Chen
    • 1
  • Lan-Lan Cui
    • 1
  1. 1.PET/CT CenterGansu Provincial HospitalLanzhouChina
  2. 2.Department of RadiologyGansu Provincial HospitalLanzhouChina

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