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Comparison of CT and PET/CT for biopsy guidance in oncological patients

  • Original Article
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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions.

Methods

We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated.

Results

Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance.

Conclusion

PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant lesions. This prospective analysis of a large number of patients demonstrated the feasibility and advantages of using PET/CT as the imaging method of choice for biopsy guidance, especially where FDG-avid foci do not show corresponding lesions on the CT scan. There were no significant differences in the ability to obtain a diagnostic specimen or in the complication rates between PET/CT and CT guidance.

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Authors and Affiliations

  1. Quanta – Diagnóstico e Terapia, Rua Almirante Tamadaré, 1000, CEP 80045-170, Curitiba, PR, Brazil

    Juliano J. Cerci, Mateos Bogoni, Carlos Cunha Pereira, Rodrigo J. Cerci, Cassiano Krauzer & João Vicente Vitola

  2. Nuclear Medicine Department, University Hospital S. Orsola-Malpighi, Bologna, Italy

    Elena Tabacchi & Stefano Fanti

  3. Vanderbilt University, Nashville, TN, USA

    Dominique Delbeke

  4. Byori - Laboratório de Patologia, Curitiba, Brazil

    Danielle Giacometti Sakamoto

Authors
  1. Juliano J. Cerci
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  2. Elena Tabacchi
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  3. Mateos Bogoni
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  4. Dominique Delbeke
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  5. Carlos Cunha Pereira
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  6. Rodrigo J. Cerci
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  7. Cassiano Krauzer
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  8. Danielle Giacometti Sakamoto
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  9. Stefano Fanti
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  10. João Vicente Vitola
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Corresponding author

Correspondence to Juliano J. Cerci.

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Cerci, J.J., Tabacchi, E., Bogoni, M. et al. Comparison of CT and PET/CT for biopsy guidance in oncological patients. Eur J Nucl Med Mol Imaging 44, 1269–1274 (2017). https://doi.org/10.1007/s00259-017-3658-8

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  • DOI: https://doi.org/10.1007/s00259-017-3658-8

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