Introduction: Positron emission tomography with computed tomography using 18-fluoro-deoxyglucose (18FDG-PET/CT) is still not applied routinely in clinical practice for the evaluation of recurrent bladder cancer. Recent guidelines recognize the importance of 18FDG-PET/CT, but multi-slice computed tomography (MSCT) is still recommended for monitoring these patients. Aim: To determine the agreement between 18FDG-PET/CT and MSCT findings in the categorization of patients into N and M stages of the disease and the agreement of two diagnostic modalities regarding the number of detected lesions. Material and methods: 31 patients (22 men and 9 women), mean age 61.2 ± 9.2 years, were included in our study after surgical treatment and histopathological confirmation of bladder cancer. Zones of pathological uptake of 18FDG were interpreted visually and semi-quantitatively using the maximum standardized uptake value (SUVmax). The agreement of 18FDG-PET/ CT findings was compared to previous MSCT using Cohen's kappa test for interobserver agreement, interpreted based on the Altman's criteria. Results: The overall agreement between 18FDG-PET/CT and MSCT in N stage of the disease was 77% (c = 0.54; moderate agreement); in stage N0 68%, N2 77%, N3 29%. In M stage, total agreement was 53% (c = 0.10; poor agreement); in stage M0 39%, M1a 22%, M1b 44%. 18FDG-PET/CT detected a total of 29 lesions in N stage of the disease, while MSCT detected 16 lesions, with the agreement of 71% (c = 0.41; moderate agreement). In the M stage of the disease, 18FDG-PET/CT detected 42 lesions and MSCT detected 30 lesions, with overall agreement of 52% (c = 0.07; poor agreement). Conclusion: Our results show that there is a moderate agreement between 18FDG-PET/CT and MSCT findings in the categorization of patients and the number of detected lesions in N stage of disease, but that 18FDG-PET/CT detects more lesions. 18FDG-PET/CT also detects a higher number of lesions in M stage, but the agreement with MSCT findings is poor.

Objective: To evaluate Tc-99m-PSMA SPECT/CT detection of biochemical recurrence (BCR) of prostate cancer across serum PSA levels in patients treated with radical prostatectomy or radiation therapy, to explore clinical/pathologic predictors of scan positivity and metastatic disease, and to assess its potential role as a pragmatic alternative when PSMA PET/CT is unavailable in resource-limited settings. Materials and Methods: In this prospective single-center study, we included 132 men with biochemical recurrence who underwent Tc-99m-PSMA SPECT/CT between January 2024 and December 2025 after predefined inclusion and exclusion criteria were applied, and they were further stratified by primary treatment (radical prostatectomy or radiation therapy). Patients were followed up for up to 6 months after imaging to verify observed findings (histopathology, confirmatory imaging and PSA response) and a logistic regression was applied to identify predictors of scan positivity and metastatic disease. Results: In men initially treated with radical prostatectomy, detection increased from 38.9% at PSA 0.2 to <2 ng/mL to 63.2% at 2 to <4 ng/mL, 71.4% at 4 to <7 ng/mL, and 90% at PSA ≥ 7 ng/mL (overall 69.1%). In the radiation therapy cohort, detection was 58.3% at PSA 2 to <4 ng/mL, rising to 85.7% at 4 to <7 ng/mL and 96% at PSA ≥ 7 ng/mL (overall 84.3%). In the multivariable analysis, PSA doubling (log2[PSA]) independently predicted scan positivity and metastatic disease in both cohorts, while seminal vesicle invasion independently predicted metastatic spread in the post-prostatectomy group. Conclusions: Tc-99m-PSMA SPECT/CT is a useful tool for detecting prostate cancer BCR, with performance strongly dependent on PSA and higher detection in patients with higher PSA levels. Increasing PSA independently predicted scan positivity and metastatic disease, while seminal vesicle invasion was independently associated with metastatic spread. In settings where PSMA PET/CT is unavailable, Tc-99m-PSMA SPECT/CT may represent a practical alternative, particularly for patients with elevated PSA.

Introduction/Objective. The goal of our research was to evaluate diagnostic and prognostic role of positron emission tomography/computed tomography (PET-CT) in patients previously treated for uterine cancer and compare it to conventional imaging methods (CIM). Methods. We analyzed 37 patients examined on PET-CT for follow-up or suspicion of uterine cancer recurrence, and who were previously treated with surgery and/or chemoradiotherapy. All patients underwent CT or magnetic resonance imaging prior to PET-CT, and were followed-up for at least one year. Results. PET-CT showed sensitivity, specificity and diagnostic accuracy in uterine cancer relapse detection of 96.3%, 70%, and 89.2%, while those values for CIM were 92.6%, 40%, and 78.4 %, respectively. Correlation of PET-CT and CIM findings was 78% (29/37). In 13 out of 25 true positive patients on CIM, PET-CT found greater number of active sites missed by conventional imaging. Positive findings on PET-CT were associated with shorter progression free survival (p = 0.023, logrank test). Conclusion. PET-CT constitutes an important diagnostic method in management of recurrent cancer of uterine corpus, demonstrating high sensitivity and accuracy. In comparison to CIM, PET-CT can discover larger number of active tumor sites, and also shows better specificity. PET-CT positive patients have worse prognosis with shorter progression free survival.