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

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 patient-based 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.