RT Journal Article SR Electronic T1 Forced Diuresis Improves the Diagnostic Accuracy of 18F-FDG PET in Abdominopelvic Malignancies JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1803 OP 1807 VO 47 IS 11 A1 Ehab M. Kamel A1 Patrice Jichlinski A1 John O. Prior A1 Jean-Yves Meuwly A1 Jean-Francois Delaloye A1 Laurent Vaucher A1 Jerome Malterre A1 Sandra Castaldo A1 Hans-Juerg Leisinger A1 Angelika Bischof Delaloye YR 2006 UL http://jnm.snmjournals.org/content/47/11/1803.abstract AB Our aim was to evaluate the role of forced diuresis in improving the diagnostic accuracy of abdominopelvic 18F-FDG PET. Methods: Thirty-two patients were enrolled. Besides the presence of known intravesical tumors or undefined renal lesions on the initial PET scan, the inclusion criterion was the appearance of indeterminate or equivocal 18F-FDG foci that extended along the course of the urinary tract and could not confidently be separated from urinary activity. For each patient, a second abdominopelvic PET study was performed after intravenous injection of 0.5 mg of furosemide per kilogram of body weight (maximum, 40 mg) coupled with parenteral infusion of physiologic saline. Results: Forced diuresis coupled with parenteral hydration eliminated any significant 18F-FDG activity from the lower urinary tract in 31 (97%) of 32 patients after the bladder had been voided 3 successive times. Twelve intravesical lesions were visualized with outstanding clarity, whereas radiologic suspicion of locally recurrent bladder tumors was ruled out in 3 patients. Among 14 indeterminate or equivocal extravesical foci, 7 were deemed of no clinical value because they disappeared after furosemide challenge, whereas 7 persisting foci were proven to be true-positive PET findings. The performance of 18F-FDG PET in characterizing 3 renal-space–occupying lesions could not be improved by our protocol. Conclusion: Furosemide challenge has the potential to noninvasively resolve the inherent 18F-FDG contrast handicap in the lower urinary tract.