Abstract: Objective To investigate the clinical value of dual-phase 18F-FDG PET/CT with oral diuretics in preoperative staging
of bladder cancer. Methods The imaging data were analyzed of 73 patients with bladder cancer undergoing preoperative
dual-phase 18F-FDG PET/CT with oral diuretic between May, 2003 and May, 2012. All the patients underwent whole-body PET/
CT scan 60 min after intravenous injection of 270-350 MBq of 18F-FDG. Additional delayed pelvic PET/CT images were
acquired after forced diuresis using oral furosemide (40 mg). All the patients underwent subsequent radical cystectomy, and
18F-FDG PET/CT findings were compared with the histopathologic results to evaluate the value of dual-phase 18F-FDG PET/CT
in preoperative staging. Results The concordance rate of dual-phase FDG PET/CT-based bladder cancer staging with the
histopathologic results was 63.0% in the 73 patients, and was 100% (7/7) for pT4 bladder cancers. With dual-phase FDG PET/
CT, the detection rate was 75.0% (6/8) for lymph node metastases, 100% (4/4) for distant metastases, and 100% (4/4) for other
concurrent primary malignancies. Conclusion Though with limited accuracy in T-staging of pTa, pT1, pT2, and pT3 bladder
cancer, dual-phase FDG PET/CT has important clinical value in staging of pT4 bladder cancer and in N-staging, M-staging and
detection of other concurrent primary malignancies.