Granulomatous Prostatitis After Intravesical Bacillus Calmette-Guérin Instillation Therapy: A Potential Cause of Incidental F-18 FDG Uptake in the Prostate Gland on F-18 FDG PET/CT in Patients with Bladder Cancer

被引：15

作者：

Kim C.-Y. ^{[1
]}

Lee S.-W. ^{[1
]}

Choi S.H. ^{[2
]}

Son S.H. ^{[1
]}

Jung J.-H. ^{[1
]}

Lee C.-H. ^{[1
]}

Jeong S.Y. ^{[1
]}

Ahn B.-C. ^{[1
]}

Lee J. ^{[1
]}

机构：

[1] Department of Nuclear Medicine, Kyungpook National University Medical Center and School of Medicine, 807 Hoguk-ro, Buk-gu, Daegu

[2] Department of Urology, Kyungpook National University Medical Center and School of Medicine, 807 Hoguk-ro, Buk-gu, Daegu

来源：

Nuclear Medicine and Molecular Imaging | 2016年 / 50卷 / 1期

关键词：

Bladder cancer; F-18 FDG PET/CT; Granulomatous prostatitis; Intravesical BCG therapy;

D O I：

10.1007/s13139-015-0364-y

中图分类号：

学科分类号：

摘要：

Purpose: This study aimed to evaluate the possibility that Bacillus Calmette-Guérin (BCG)-induced granulomatous prostatitis can be a potential cause of benign F-18 FDG uptake. Methods: A total of 395 bladder cancer patients who underwent F-18 FDG PET/CT (PET/CT) were retrospectively evaluated. Patients were divided into two groups according to BCG therapy status. Elapsed time after BCG therapy, serum PSA level, results of prostate biopsy, and the SUVmax and uptake pattern in the prostate gland were reviewed. For patients who underwent follow-up PET/CT, the changes in SUVmax were calculated. Results: While 35 % of patients showed prostate uptake in the BCG therapy group, only 1 % showed prostate uptake in the non-BCG therapy group (p < 0.001). Among 49 patients with FDG-avid prostate lesions, none had suspected malignancy during the follow-up period (median: 16 months). Five patients revealed granulomatous prostatitis on biopsy. The incidence of FDG-avid prostate lesions was significantly higher if the elapsed time after BCG therapy was less than 1 year compared to more than 1 year (p < 0.001). Serum PSA was normal in 88 % of patients. All patients with incidental F-18 FDG uptake in the prostate gland showed focal or multifocal prostate uptake, and median SUVmax was 4.7. In 16 patients who underwent follow-up PET/CT, SUVmax was decreased in 14 patients (88 %) without treatment, and no patients demonstrated further increased prostate uptake (p < 0.001). Conclusions: BCG-induced granulomatous prostatitis can be a potential cause of benign F-18 FDG uptake, especially in those with a history of bladder cancer treated with BCG. In BCG-induced granulomatous prostatitis, focal or multifocal prostate uptake is frequently seen within 1 year after BCG therapy, and the intensity of prostate uptake is decreased on the follow-up PET/CT without any treatment. © 2015, Korean Society of Nuclear Medicine.

引用

页码：31 / 37

页数：6

共 16 条

[1]

Han E.J., OJ H., Choi W.H., Yoo I.R., Chung S.K., Significance of incidental focal uptake in prostate on 18-fluoro-2-deoxyglucose positron emission tomography CT images, Br J Radiol, 83, pp. 915-920, (2010)

[2]

Hwang I., Chong A., Jung S.I., Hwang E.C., Kim S.O., Kang T.W., Et al., Is further evaluation needed for incidental focal uptake in the prostate in 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography images?, Ann Nucl Med, 27, pp. 140-145, (2013)

[3]

Kao P.F., Chou Y.H., Lai C.W., Diffuse FDG uptake in acute prostatitis, Clin Nucl Med, 33, pp. 308-310, (2008)

[4]

Wilkinson C., Chowdhury F., Scarsbrook A., Smith J., BCG-induced granulomatous prostatitis—an incidental finding on FDG PET-CT, Clin Imaging, 36, pp. 413-415, (2012)

[5]

Ilgan S., Koca G., Gundogdu S., Incidental detection of granulomatous prostatitis by F-18 FDG PET/CT in a patient with bladder cancer: a rare complication of BCG instillation therapy, Clin Nucl Med, 34, pp. 613-614, (2009)

[6]

Kim C.Y., Lee S.W., Yoon G., Jeong S.Y., Ahn B.C., Lee J., Incidental detection of increased (18) F-FDG uptake and its follow-up in patients with granulomatous prostatitis after BCG treatment for urinary bladder cancer, Hell J Nucl Med, 17, pp. 204-207, (2014)

[7]

Morales A., Eidinger D., Bruce A.W., Intracavitary bacillus Calmette-Guerin in the treatment of superficial bladder tumors, J Urol, 116, pp. 180-183, (1976)

[8]

LaFontaine P.D., Middleman B.R., Graham S.D., Sanders W.H., Incidence of granulomatous prostatitis and acid-fast bacilli after intravesical BCG therapy, Urology, 49, pp. 363-366, (1997)

[9]

Bevers R.F., Kurth K.H., Schamhart D.H., Role of urothelial cells in BCG immunotherapy for superficial bladder cancer, Br J Cancer, 91, pp. 607-612, (2004)

[10]

Balasar M., Dogan M., Kandemir A., Taskapu H.H., Cicekci F., Toy H., Et al., Investigation of granulomatous prostatitis incidence following intravesical BCG therapy, Int J Clin Exp Med, 7, pp. 1554-1557, (2014)

← 1 2 →