Positron emission tomography (PET) using ((18)F)2-fluoro-D-2-desoxyglucose (FDG) has been shown to be a highly sensitive and specific imaging modality in the diagnosis of primary and recurrent
tumors and in the control of
therapies in numerous non-
urologic cancers. It was the aim of this review to validate the significance of PET as a diagnostic tool in malignant
tumors of the urogenital tract. A systematic review of the current literature concerning the role of PET for malignant
tumors of the kidney, testicles, prostate, and bladder was carried out. The role of FDG PET for
renal cell cancer can be seen in the detection of recurrences after definitive local
therapy and
metastases. The higher sensitivity of PET in comparison to other therapeutic modalities (CT, ultrasound, MRI) in recurrent and metastatic
renal cell cancer suggests a supplemental role of this diagnostic procedure to
complement other imaging modalities.The clinical value of PET is established for the identification of vital
tumor tissue after
chemotherapy of seminomatous
germ cell tumors. This diagnostic method has little significance for primary
tumor staging and diagnosis of non-seminomatous
germ cell tumor because of the high probability of false-negative results in adult
teratomas. FDG PET is not sensitive enough in the diagnosis of primary or recurrent
tumors in prostate or
bladder cancer. Also PET did not prove to be superior to conventional bone scintigram in the detection of mostly osteoblastic
metastases in
prostate cancer. The recent use of alternative tracers, which are partly not eliminated by urinary secretion (
acetate,
choline) has increased the sensitivity and specificity of PET also in this
tumor entity so that further clinical investigations are needed to validate these technical modifications in their significance for this imaging modality. PET appears to be sufficiently evaluated only for the diagnostic follow-up of patients with seminomatous
germ cell tumors after
chemotherapy to regard it is the diagnostic tool of first choice. For all other
tumors of the urogenital tract this proof is still awaited.