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Journal of Clinical Imaging Science
Editor‑in‑Chief: Vikram S. Dogra, MD OPEN ACCESS Department of Imaging Sciences, University of HTML format Rochester Medical Center, Rochester, USA For entire Editorial Board visit : www.clinicalimagingscience.org/editorialboard.asp www.clinicalimagingscience.org
ORIGINAL ARTICLE
Contrast Enhanced Computed Tomography Characterization of Fluorodeoxygluocose‑Avid Regional and Non‑Regional Lymph Nodes in Patients with Suspicion of Metastatic Bladder Cancer Muhammad A. Chaudhry1,2, Richard Wahl1,2, Lujaien Al‑Rubaiey Kadhim3, Atif Zaheer1 Russell H. Morgan Department of Radiology and Radiological Health Sciences, Division of Diagnostic Imaging, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA, 2Division of Nuclear Medicine, 3Tawam Molecular Imaging Centre, Al Ain, United Arab Emirates 1
Address for correspondence: Dr. Atif Zaheer, Johns Hopkins University School of Medicine, JHOC 3235A Radiology, 601 North Caroline Street, Baltimore, MD 21287, USA. E‑mail:
[email protected]
ABSTRACT
Objective: The objective of this study is to assess if size alone can predict the presence of metastatic disease within lymph nodes seen on contrast enhanced‑computed tomography (CE‑CT) in patients with suspicion of metastatic bladder cancer and also to evaluate the nodal distribution and morphological characteristics of fluorodeoxygluocose (FDG) avid lymph nodes on CE‑CT. Materials and Methods: A retrospective analysis from 2002 to 2009 was performed on patients with suspicion of recurrent disease undergoing restaging FDG-positron emission tomography (PET)/CT. Standardized uptake value (SUVmax) adjusted for lean body mass was recorded in abnormal lymph nodes in the abdominopelvic region. Distribution, size, shape, presence of necrosis and clustering of the FDG‑avid lymph nodes was assessed on CE‑CT obtained within 4 weeks of the PET/CT. The abnormal nodes were then compared with non‑FDG avid lymph nodes on the contralateral side serving as control. Results: A total of 103 lymph nodes were found to be FDG‑avid in 14 patients on 17 PET/CT examinations. Overall, mean SULmax was 4.7 (range: 1.6‑10.7), which is significantly higher than background of 1.5 (P
