Indications

The non-urological indications are not discussed here. Currently, though there are no absolute urological indications, PET may contribute in the following pathological processes:

• Testicular tumors

■ Primary tumor staging

■ Early detection of recurrent disease

■ Assessment of residual tumor burden after therapy

• Renal cell cancer

■ Initial staging of local and distant disease

■ Detection of recurrence

• Bladder cancer

■ Detection of recurrent disease (if other imaging ambivalent)

• Detection of bony metastases (if bone scan equivocal) Technique and radiation

The are no specific contraindications to PET scanning except for women who are pregnant and breastfeeding.

Patient preparation

• Patients advised to avoid food for 4-6 hours and oral intake restricted to non-sugary clear fluid

• Blood glucose estimation is performed just prior to the examination to ensure low glucose levels (high levels inhibit FDG uptake by cells)

• In addition, buscopan (20 mg) and/or diazepam may be administered to reduce FDG uptake by the intestines and muscles, respectively

• A preliminary background scan is performed before up to 400 MBq of FDG is injected intravenously

• Imaging is performed between 45 and 90 minutes after tracer injection

• A whole body scan can be performed or imaging restricted to the area of interest, with or without simultaneous CT scanning

A maximal injected dose of 400 MBq corresponds to an effective radiation dose of 10 mSv (equivalent to up to 6 years of background radiation).

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