The Value of FDG PET/CT in Penile Cancer: An Update

Penile cancer is a rare malignancy predominantly of squamous cell histology, whose prognosis is strongly influenced by lymph node involvement. Conventional imaging methods such as CT, MRI, and ultrasound have limitations in assessing metastatic spread. [¹⁸F]FDG PET/CT, a metabolic imaging technique, has shown increasing value in the staging, restaging, and treatment monitoring of penile cancer. Evidence, although limited, demonstrates high sensitivity and specificity, particularly in detecting inguinal and pelvic lymph node metastases, outperforming conventional imaging in most cases. [¹⁸F]FDG PET/CT also aids in identifying distant metastases and distinguishing viable tumor tissue from post-treatment fibrosis. Preliminary data suggest a prognostic role of SUVmax values in correlating with tumor aggressiveness and survival outcomes. Current guidelines recommend its use mainly in patients with nodal involvement or inconclusive conventional imaging. Overall, [¹⁸F]FDG PET/CT represents a complementary tool that enhances staging accuracy, risk stratification, and treatment planning in penile cancer.