Penis/Testis/Urethra: Benign & Malignant Disease (III)
Moderated Poster Session 35
947 THE VALUE OF PET/CT FOR STAGING IN PENILE CARCINOMAS BEFORE AND AFTER CHEMOTHERAPY

https://doi.org/10.1016/j.juro.2013.02.526Get rights and content

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INTRODUCTION AND OBJECTIVES

Neoadjuvant chemotherapy before inguinal lymphadenectomy seems to improve the prognosis of patients with penile cancer and regional lymph node disease. However, apart from clinical response and postoperative histology there are no reliable predictors for chemotherapy response. After adjuvant chemotherapy, response is often inadequately assessed by available imaging. We assessed the usefulness of F-18 FDG PET/CT for staging penile cancer patients before and after systemic chemotherapy.

METHODS

9 patients (mean age 62 years, range 43-77) with penile cancer underwent F-18- FDG PET/CT for staging before neoadjuvant or adjuvant chemotherapy. 5/9 patients had a follow-up FDG PET/CT after chemotherapy. PET/CT imaging (Philips Gemini TF 16) was performed 90 minutes after injection of a mean activity of 224 MBq F-18 FDG (Fluorodeoxyglucose). SUVmax and mean of each lesion was defined using VOIs comparing 4 different software tools (Hermes® Medical Hybrid Viewer 2.0, Siemens Syngo True D®,

RESULTS

In 2 patients after penile surgery and after local penile surgery plus inguinal lymphadenectomy no focal lesions were seen. In 7 patients examined before chemotherapy, 26 lymph nodes and 6 local penile lesions were identified, while no significant difference was shown in SUVmax and SUVmean between the 4 software tools. In 5 patients with follow-up PET/CT after chemotherapy, 15 nodal lesions and 2 local penile lesions showed a decrease of FDG-uptake, while 6 nodal lesions showed an increase in

CONCLUSIONS

FDG PET/CT seems to be a valuable tool for patients with penile squamous cell carcinoma to identify lymph node metastases. It might be limited in local staging early after surgery due to postoperative changes. In staging before chemotherapy the 4 software tools performed equally. Therapy monitoring after chemotherapy was feasible, but there were differences between the software tools, possibly due to methodical differences between the tools.

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