Performance of intra-procedural 18-fluorodeoxyglucose PET/CT-guided biopsies for lesions suspected of malignancy but poorly visualized with other modalities

• DOI: 10.1007/s00259-014-2852-1
• Publication Date: 2014-08-08T13:19:09Z
• Authors: F. Cornelis; M. Silk; H. Schoder; H. Takaki; J. C. Durack; J. P. Erinjeri; C. T. Sofocleous; R. H. Siegelbaum; M. Maybody; S. B. Solomon
• Keywords: Adult; Image-Guided Biopsy; Male; Adolescent; Middle Aged; Multimodal Imaging; Bone and Bones; 3. Good health; 03 medical and health sciences; Subcutaneous Tissue; 0302 clinical medicine; Liver; Fluorodeoxyglucose F18; Predictive Value of Tests; Neoplasms; Positron-Emission Tomography; Abdomen; Humans; Female; Radiopharmaceuticals; Child; Lung; Aged

We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural (18)F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging.From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7-15.9 cm; SD, 2.9 cm) in bones (n = 33), liver (n = 26), soft tissues (n = 18), lung (n = 15) and abdomen (n = 14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed.Biopsies were positive for malignancy in 76 cases (71.7%, 76/106) and for benign tissue in 30 cases (28.3%, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3%, 100/106) requiring no further exploration, and for the six others (5.7%, 6/106) benign diagnoses were confirmed after surgery (n = 4) or follow-up (n = 2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100%. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV > 4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7%, 4/106).Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions.