Granulomatous Prostatitis After Intravesical Bacillus Calmette-Guérin Instillation Therapy: A Potential Cause of Incidental F-18 FDG Uptake in the Prostate Gland on F-18 FDG PET/CT in Patients with Bladder Cancer.

Content Provider	Europe PMC
Author	Kim, Choon-Young Lee, Sang-Woo Choi, Seock Hwan Son, Seung Hyun Jung, Ji-hoon Lee, Chang-Hee Jeong, Shin Young Ahn, Byeong-Cheol Lee, Jaetae
Abstract	Purpose This study aimed to evaluate the possibility that Bacillus Calmette-Guérin (BCG)-induced granulomatous prostatitis can be a potential cause of benign F-18 FDG uptake. Methods A total of 395 bladder cancer patients who underwent F-18 FDG PET/CT (PET/CT) were retrospectively evaluated. Patients were divided into two groups according to BCG therapy status. Elapsed time after BCG therapy, serum PSA level, results of prostate biopsy, and the SUVmax and uptake pattern in the prostate gland were reviewed. For patients who underwent follow-up PET/CT, the changes in SUVmax were calculated. Results While 35 % of patients showed prostate uptake in the BCG therapy group, only 1 % showed prostate uptake in the non-BCG therapy group (p < 0.001). Among 49 patients with FDG-avid prostate lesions, none had suspected malignancy during the follow-up period (median: 16 months). Five patients revealed granulomatous prostatitis on biopsy. The incidence of FDG-avid prostate lesions was significantly higher if the elapsed time after BCG therapy was less than 1 year compared to more than 1 year (p < 0.001). Serum PSA was normal in 88 % of patients. All patients with incidental F-18 FDG uptake in the prostate gland showed focal or multifocal prostate uptake, and median SUVmax was 4.7. In 16 patients who underwent follow-up PET/CT, SUVmax was decreased in 14 patients (88 %) without treatment, and no patients demonstrated further increased prostate uptake (p < 0.001). Conclusions BCG-induced granulomatous prostatitis can be a potential cause of benign F-18 FDG uptake, especially in those with a history of bladder cancer treated with BCG. In BCG-induced granulomatous prostatitis, focal or multifocal prostate uptake is frequently seen within 1 year after BCG therapy, and the intensity of prostate uptake is decreased on the follow-up PET/CT without any treatment.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4762869&blobtype=pdf
ISSN	18693474
Volume Number	50
DOI	10.1007/s13139-015-0364-y
PubMed Central reference number	PMC4762869
Issue Number	1
PubMed reference number	26941857
Journal	Nuclear Medicine and Molecular Imaging [Nucl Med Mol Imaging]
e-ISSN	18693482
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2015-09-11
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	© Korean Society of Nuclear Medicine 2015
Subject Keyword	Bladder cancer Intravesical BCG therapy F-18 FDG PET/CT Granulomatous prostatitis
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging