title: The impact of coaxial core biopsy guided by FDG PET/CT in oncological patients.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of PET/CT, Quanta-Diagnóstico e Terapia, Rua Almirante Tamadaré 1000, Curitiba, PR, Brazil. cercijuliano@hotmail.com
authors.forename: Juliano Julio
authors.initials: JJ
authors.lastname: Cerci
authors.forename: Carlos Cunha
authors.initials: CC
authors.lastname: Pereira Neto
authors.forename: Cassiano
authors.initials: C
authors.lastname: Krauzer
authors.forename: Danielle Giacometti
authors.initials: DG
authors.lastname: Sakamoto
authors.forename: João Vicente
authors.initials: JV
authors.lastname: Vitola
mesh_terms: D001707:Biopsy, Needle; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D064847:Multimodal Imaging; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18