Clinical value of fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in penile cancer

Abstract

Purpose This study investigated the value of Fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging in the management of patients with advanced penile cancer. Patients and Methods Between January 2009 and August 2012, 48 patients with penile cancer at our center underwent FDG-PET/CT after CT (n=39) or magnetic resonance imaging (MRI; n=9). The accuracy of FDG-PET/CT was assessed with both organ-based and patientbased analyses. FDG-PET/CT findings were validated by either biopsy or serial CT/ MRI. Clinician questionnaires performed before and after FDG-PET/CT evaluated whether the scan results affected management. Results One hundred fifteen individual lesions were evaluable in 42 patients for the organ-based analysis. Overall sensitivity was 85% and specificity was 86%. In the patient-based analysis, overall sensitivity and specificity were 82% and 93%, respectively. Pre- and post-PET surveys showed that FDG-PET/CT detected more malignant diseases than CT/MRI in 33% patients. Planned treatments were changed in 57% patients after FDG-PET/CT scan. Conclusion FDG-PET/CT has good sensitivity and specificity in the detection of metastatic penile cancer. It provides more diagnostic information to enhance clinical management than CT/MRI.