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European Journal of Nuclear Medicine and Molecular Imaging

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01-01-2013 | Short Communication

The impact of coaxial core biopsy guided by FDG PET/CT in oncological patients

Authors: Juliano Julio Cerci, Carlos Cunha Pereira Neto, Cassiano Krauzer, Danielle Giacometti Sakamoto, João Vicente Vitola

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2013

Abstract

Objective

When deciding on therapy, FDG PET/CT-positive results should be confirmed by histology if possible. We evaluated the impact of percutaneous PET/CT-guided biopsies on histological confirmation of PET/CT-positive lesions.

Methods

We prospectively evaluated 126 patients who had undergone a PET/CT scan with positive results with an indication for histological evaluation of lesions. Imaging was performed in a PET/CT scanner with a fluoroscopic imaging system. A total of 130 lesions were accessed by PET/CT-guided biopsy. The technical feasibility, clinical success and complication rates of PET/CT-guided biopsies were evaluated.

Results

Of 130 PET/CT-positive lesions, 128 (98.5 %) were successfully accessed and representative tissue samples obtained. Two lesions were reaccessed due to inconclusive histological results. Histology showed that 99 of the 130 lesions (76.2 %) were malignant, and 31 lesions (23.8 %) were benign (inflammatory cells or necrotic tissue); these patients had no recurrence of disease after a minimum follow-up of 6 months. Also, in 23 of the 130 lesions (17.7 %), the patient was referred for the PET/CT-guided biopsy due to a previous nontumoral biopsy result, and of these 23 lesions, 21 were found to be malignant. The complication rates were: pneumothorax in 15/130 (11.5 %; resolved spontaneously), haemoptysis in 2/130 (1.5 %) and severe haemothorax in 1/130 (0.8 %); there was no procedure-related mortality.

Conclusion

PET/CT-guided biopsy is feasible and may optimize the diagnostic yield of image-guided interventions. Also, PET/CT-positive lesions with no morphological correlation may now be accessible to percutaneous interventions.

Juweid ME, Stroobants S, Hoekstra OS, Mottaghy FM, Dietlein M, Guermazi A, et al.; Imaging Subcommittee of International Harmonization Project in Lymphoma. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol. 2007;25(5):571–8.PubMedCrossRef

Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al.; International harmonization project on lymphoma. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579–86.

Isasi CR, Lu P, Blaufoux D. A metaanalysis of 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography in the staging and restaging of patients with lymphoma. Cancer. 2005;104(5):1066–74.

Zijlstra JM, Lindauer-van der Werf G, Hoekstra OS, Hooft L, Riphagen II, Huijgens PC. 18F-fluoro-deoxyglucose positron emission tomography for post-treatment evaluation of malignant lymphoma: a systematic review. Haematologica. 2006;91:522–9.PubMed

Facey K, Bradbury I, Laking G, Payne E. Overview of the clinical effectiveness of positron emission tomography imaging in selected cancers. Health Technol Assess. 2007;11(44):iii–iv, iv–207.

Spaepen K, Stroobants S, Dupont P, Van Steenweghen S, Thomas J, Vandenberghe P, et al. Prognostic value of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose ([18F]FDG) after first-line chemotherapy in non-Hodgkin’s lymphoma: is [18F]FDG-PET a valid alternative to conventional diagnostic methods? J Clin Oncol. 2001;19(2):414–9.PubMed

Jerusalem G, Beguin Y, Fassotte MF, Najjar F, Paulus P, Rigo P, et al. Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood. 1999;94(2):429–33.PubMed

Kostakoglu L, Coleman M, Leonard JP, Kuji I, Zoe H, Goldsmith SJ. PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin’s disease. J Nucl Med. 2002;43:1018–27.PubMed

Mikhaeel NG, Timothy AR, O’Doherty MJ, Hain S, Maisey MN. 18-FDG-PET as a prognostic indicator in the treatment of aggressive non-Hodgkin’s lymphoma: comparison with CT. Leuk Lymphoma. 2000;39:543–53.PubMedCrossRef

10.

Weihrauch MR, Re D, Scheidhauer K, Ansén S, Dietlein M, Bischoff S, et al. Thoracic positron emission tomography using 18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin disease. Blood. 2001;98(10):2930–4.PubMedCrossRef

11.

Podoloff DA, Ball DW, Ben-Josef E, Benson 3rd AB, Cohen SJ, Coleman RE, et al. NCCN task force: clinical utility of PET in a variety of tumor types. J Natl Compr Canc Netw. 2009;7 Suppl 2:S1–26.PubMed

12.

Antoch G, Saoudi N, Kuehl H, Dahmen G, Mueller SP, Beyer T, et al. Accuracy of whole-body dual-modality fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography (FDG-PET/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol. 2004;22(21):4357–68.PubMedCrossRef

13.

Mahner S, Schirrmacher S, Brenner W, Jenicke L, Habermann CR, Avril N, et al. Comparison between positron emission tomography using 2-[fluorine-18]fluoro-2-deoxy-D-glucose, conventional imaging and computed tomography for staging of breast cancer. Ann Oncol. 2008;19(7):1249–54.PubMedCrossRef

14.

Cerci JJ, Trindade E, Buccheri V, Fanti S, Coutinho AM, Zanoni L, et al. Consistency of FDG-PET accuracy and cost-effectiveness in initial staging of patients with Hodgkin lymphoma across jurisdictions. Clin Lymphoma Myeloma Leuk. 2011;11(4):314–20.PubMedCrossRef

15.

Klaeser B, Wiskirchen J, Wartenberg J, Weitzel T, Schmid RA, Mueller MD, et al. PET/CT-guided biopsies of metabolically active bone lesions: applications and clinical impact. Eur J Nucl Med Mol Imaging. 2010;37(11):2027–36.PubMedCrossRef

16.

Ng AK, Bernardo MP, Weller E, Backstrand KH, Silver B, Marcus KC, et al. Long-term survival and competing causes of death in patients with early-stage Hodgkin’s disease treated at age 50 or younger. J Clin Oncol. 2002;20:2101–8.PubMedCrossRef

17.

Huch K, Röderer G, Ulmar B, Reichel H. CT-guided interventions in orthopedics. Arch Orthop Trauma Surg. 2007;127(8):677–83.PubMedCrossRef

18.

Grand DJ, Atalay MA, Cronan JJ, Mayo-Smith WW, Dupuy DE. CT-guided percutaneous lung biopsy: comparison of conventional CT fluoroscopy to CT fluoroscopy with electromagnetic navigation system in 60 consecutive patients. Eur J Radiol. 2011;79(2):e133–6.PubMedCrossRef

19.

Omura MC, Motamedi K, Uybico S, Nelson SD, Seeger LL. Revisiting CT-guided percutaneous core needle biopsy of musculoskeletal lesions: contributors to biopsy success. AJR Am J Roentgenol. 2011;197(2):457–61.PubMedCrossRef

20.

Wu CC, Maher MM, Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management. AJR Am J Roentgenol. 2011;196(6):W678–82.PubMedCrossRef

21.

Veit P, Kuehle C, Beyer T, et al. Accuracy of combined PET/CT in image-guided interventions of liver lesions: an ex-vivo-study. World J Gastroenterol. 2006;12:2388–93.PubMed

22.

Tatli S, Gerbaudo VH, Feeley CM, Shyn PB, Tuncali K, Silverman SG. PET/CT-guided percutaneous biopsy of abdominal masses: initial experience. J Vasc Interv Radiol. 2011;22(4):507–14.PubMedCrossRef

23.

O’Sullivan PJ, Rohren EM, Madewell JE. Positron emission tomography-CT imaging in guiding musculoskeletal biopsy. Radiol Clin North Am. 2008;46(3):475–86, v.

24.

Yamauchi Y, Izumi Y, Nakatsuka S, Inoue M, Hayashi Y, Mukai M, et al. Diagnostic performance of percutaneous core needle lung biopsy under multi-CT fluoroscopic guidance for ground-glass opacity pulmonary lesions. Eur J Radiol. 2011;79(2):e85–9.PubMedCrossRef

25.

Tomozawa Y, Inaba Y, Yamaura H, Sato Y, Kato M, Kanamoto T, et al. Clinical value of CT-guided needle biopsy for retroperitoneal lesions. Korean J Radiol. 2011;12(3):351–7.PubMedCrossRef

26.

Tsai IC, Tsai WL, Chen MC, Chang GC, Tzeng WS, Chan SW, et al. CT-guided core biopsy of lung lesions: a primer. AJR Am J Roentgenol. 2009;193(5):1228–35.PubMedCrossRef

Title: The impact of coaxial core biopsy guided by FDG PET/CT in oncological patients
Authors: Juliano Julio Cerci
Carlos Cunha Pereira Neto
Cassiano Krauzer
Danielle Giacometti Sakamoto
João Vicente Vitola
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-012-2263-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The impact of coaxial core biopsy guided by FDG PET/CT in oncological patients

Abstract

Objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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