TY - JOUR T1 - Forced Diuresis Improves the Diagnostic Accuracy of <sup>18</sup>F-FDG PET in Abdominopelvic Malignancies JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1803 LP - 1807 VL - 47 IS - 11 AU - Ehab M. Kamel AU - Patrice Jichlinski AU - John O. Prior AU - Jean-Yves Meuwly AU - Jean-Francois Delaloye AU - Laurent Vaucher AU - Jerome Malterre AU - Sandra Castaldo AU - Hans-Juerg Leisinger AU - Angelika Bischof Delaloye Y1 - 2006/11/01 UR - http://jnm.snmjournals.org/content/47/11/1803.abstract N2 - 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. ER -