Fig. 3

Forty-five years old patient, having history of hematuria underwent cystoscopy and histopathology revealing transitional cell carcinoma, related to the anterior wall of the UB. a Axial post-contrast CT revealed mild non-uniform mural thickening related to the anterior and left ventrolateral walls of the UB (yellow arrows). b Corresponding post-diuretic delayed fused PET CT image revealed scanty mural avidity [SUV max 3.9], related to the lesion [over the washed urine background in the bladder lumen]. Three months after regional pelvic irradiation, the bladder had become contracted having circumferential non-uniform mural thickening reaching 13.2 mm in maximal thickness (d), showing intense ventral and left ventrolateral mural activity [SUV max 29.6] in the corresponding post-diuretic delayed fused PET CT image (e) with development of multiple bilateral iliac and paraaortic as well as right inguinal (green arrow) metastatic hypermetabolic lymphadenopathies (f; yellow arrows). Moreover, the development of mild bilateral back pressure changes and retained tracer in the ureters and collecting systems (f)