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Comparative Study
. 2024 Sep 3;65(9):1357-1363.
doi: 10.2967/jnumed.124.267474.

Role of 64CuCl2 PET/CT in Detecting and Staging Muscle-Invasive Bladder Cancer: Comparison with Contrast-Enhanced CT and 18F-FDG PET/CT

Arnoldo Piccardo  1 , Gianluca Bottoni  1 , Cristina Puppo  2 , Michela Massollo  1 , Martina Ugolini  1 , Mehrdad Shoushtari Zadeh Naseri  1 , Enrico Melani  2 , Laura Tomasello  3 , Monica Boitano  4 , Andrea DeCensi  4 , Beatrice Sambucco  5 , Fabio Campodonico  6 , Vania Altrinetti  1 , Marco Ennas  6 , Alessia Urru  7 , Carlo Luigi Augusto Negro  8 , Luca Timossi  8 , Giorgio Treglia  9   10   11 , Carlo Introini  6 , Francesco Fiz  12
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Free article
Comparative Study

Role of 64CuCl2 PET/CT in Detecting and Staging Muscle-Invasive Bladder Cancer: Comparison with Contrast-Enhanced CT and 18F-FDG PET/CT

Arnoldo Piccardo et al. J Nucl Med. .
Free article

Abstract

Molecular imaging of muscle-invasive bladder cancer (MBC) is restricted to its locoregional and distant metastases, since most radiopharmaceuticals have a urinary excretion that limits the visualization of the primary tumor. 64CuCl2 , a positron-emitting radiotracer with nearly exclusive biliary elimination, could be well suited to exploring urinary tract neoplasms. In this study, we evaluated the feasibility of 64CuCl2-based staging of patients with MBC; furthermore, we compared the diagnostic capability of this method with those of the current gold standards, that is, contrast-enhanced CT (ceCT) and 18F-FDG PET/CT. Methods: We prospectively enrolled patients referred to our institution for pathology-confirmed MBC staging/restaging between September 2021 and January 2023. All patients underwent ceCT, 18F-FDG, and 64CuCl2 PET/CT within 2 wk. Patient-based analysis and lesion-based analysis were performed for all of the potentially affected districts (overall, bladder wall, lymph nodes, skeleton, liver, lung, and pelvic soft tissue). Results: Forty-two patients (9 women) were enrolled. Thirty-six (86%) had evidence of disease, with a total of 353 disease sites. On patient-based analysis, ceCT and 64CuCl2 PET/CT showed higher sensitivity than 18F-FDG PET/CT in detecting the primary tumor (P < 0.001); moreover, 64CuCl2 PET/CT was slightly more sensitive than 18F-FDG PET/CT in disclosing soft-tissue lesions (P < 0.05). Both PET methods were more specific and accurate than ceCT in classifying nodal lesions (P < 0.05). On lesion-based analysis, 64CuCl2 PET/CT outperformed 18F-FDG PET/CT and ceCT in detecting disease localizations overall (P < 0.001), in the lymph nodes (P < 0.01), in the skeleton (P < 0.001), and in the soft tissue (P < 0.05). Conclusion: 64CuCl2 PET/CT appears to be a sensitive modality for staging/restaging of MBC and might represent a "one-stop shop" diagnostic method in these scenarios.

Keywords: 64CuCl2; PET/CT; copper; muscle-invasive bladder cancer; nuclear medicine; staging.

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