title: Impact of automated hotspot detection for (18)FET PET-guided stereotactic biopsy.
abstract: OBJECTIVE
  The aim of this study was to explore the impact of automated hotspot detection on surgical planning of (18)FET PET-guided stereotactic serial biopsy.
  
  
  METHODS
  Imaging of ten patients with brain lesions detected by MRI and showing increased (18)FET uptake on PET who were retrospectively and randomly assigned to compose the study. Stereotactic biopsy plans (PET-guided and MR-guided) were performed by two neurosurgeons for each patient, independently and blinded. For PET-guided plans, biopsy target was achieved by means of an automated hotspot detection system. MR-guided plans targeted contrast enhancement areas or hyperintense areas in T2-weighted sequences. FET uptake ratio (UR) was determined in the biopsy trajectory across the lesion. Highest UR (HUR) from both planning techniques was compared.
  
  
  RESULTS
  Each single HUR obtained through PET-guided technique was higher than correspondent values from MR-guided technique. Mean HUR of 2.41 (SE ± 0.23) for PET-guided plans and 1.85 (±0.16) for MR-guided plans were respectively obtained. This difference was statistically significant (p = 0.002).
  
  
  CONCLUSIONS
  The use of an automated hotspot detection system was able to provide higher FET HUR along stereotactic biopsy trajectories in comparison to those from MR-guided plans. The use of specially designed computational tools may refine surgical planning by improving biopsy targeting.
authors: Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Neurosurgical Clinic, University Medical Center Freiburg, Breisacher Straße 64, Freiburg, D-79106, Germany, thomas.reithmeier@uniklinik-freiburg.de.
authors: Thomas
authors: T
authors: Reithmeier
authors: Joacir
authors: J
authors: Cordeiro
authors: Michael
authors: M
authors: Mix
authors: Michael
authors: M
authors: Trippel
authors: Christoph
authors: C
authors: Rottenburger
authors: Guido
authors: G
authors: Nikkhah
mesh_terms: D000328:Adult; D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013238:Stereotaxic Techniques; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18