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

  • Juliano J. Cerci
  • Elena Tabacchi
  • Mateos Bogoni
  • Dominique Delbeke
  • Carlos Cunha Pereira
  • Rodrigo J. Cerci
  • Cassiano Krauzer
  • Danielle Giacometti Sakamoto
  • Stefano Fanti
  • João Vicente Vitola
Original Article

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.

Keywords

PET/CT-guided biopsy CT-guided biopsy Cancer FDG PET/CT 

Notes

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Juliano J. Cerci
    • 1
  • Elena Tabacchi
    • 2
  • Mateos Bogoni
    • 1
  • Dominique Delbeke
    • 3
  • Carlos Cunha Pereira
    • 1
  • Rodrigo J. Cerci
    • 1
  • Cassiano Krauzer
    • 1
  • Danielle Giacometti Sakamoto
    • 4
  • Stefano Fanti
    • 2
  • João Vicente Vitola
    • 1
  1. 1.Quanta – Diagnóstico e TerapiaCuritibaBrazil
  2. 2.Nuclear Medicine DepartmentUniversity Hospital S. Orsola-MalpighiBolognaItaly
  3. 3.Vanderbilt UniversityNashvilleUSA
  4. 4.Byori - Laboratório de PatologiaCuritibaBrazil

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