Fluorodeoxyglucose positron emission tomography studies in diagnosis and staging of clinically organ-confined prostate cancer

Objectives. To determine the value of 18-fluoro-2-deoxyglucose (FDG) positr on emission tomography (PET) studies in the evaluation of patients with org an-confined prostate cancer. This imaging method has previously found littl e usefulness in localized prostate tumors because of excretion of the isoto pe into the urine, masking any lower urinary tract lesions. We evaluated th is imaging modality using hydration, furosemide, and bladder emptying befor e the procedure to evacuate the nonspecific isotope in the urine. Methods. FDG PET scans were performed on 24 patients diagnosed with clinica lly organ-confined prostate cancer. No patient had received any prior treat ments for the cancer. FDG PET scans were performed 1 hour after injection o f 15 mCi of F-18 deoxyglucose. Patients were scanned from the base of the s kull through the inguinal region (including the pelvis). Additional signal attenuation-corrected images of the inguinal region were acquired 30 minute s after intravenous injection of 40 mg of furosemide. The final diagnosis w as made by histologic examination, correlative imaging studies, and/or clin ical follow-up. Results. FDG PET studies were negative in 23 of the 24 organ-confined prost ate cancers and the study was only faintly positive in 1 tumor (4.0% sensit ivity). Conclusions. FDG PET is not a useful test in the evaluation of clinically o rgan-confined prostate cancer. UROLOGY 57: 108-111, 2001. (C) 2001, Elsevie r Science Inc.