title: Performance of intra-procedural 18-fluorodeoxyglucose PET/CT-guided biopsies for lesions suspected of malignancy but poorly visualized with other modalities.
abstract: OBJECTIVE
  We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural (18)F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging.
  
  
  METHODS
  From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7-15.9 cm; SD, 2.9 cm) in bones (n = 33), liver (n = 26), soft tissues (n = 18), lung (n = 15) and abdomen (n = 14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed.
  
  
  RESULTS
  Biopsies were positive for malignancy in 76 cases (71.7%, 76/106) and for benign tissue in 30 cases (28.3%, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3%, 100/106) requiring no further exploration, and for the six others (5.7%, 6/106) benign diagnoses were confirmed after surgery (n = 4) or follow-up (n = 2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100%. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV > 4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7%, 4/106).
  
  
  CONCLUSIONS
  Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA, francois.cornelis@chu-bordeaux.fr.
authors.forename: F
authors.initials: F
authors.lastname: Cornelis
authors.forename: M
authors.initials: M
authors.lastname: Silk
authors.forename: H
authors.initials: H
authors.lastname: Schoder
authors.forename: H
authors.initials: H
authors.lastname: Takaki
authors.forename: J C
authors.initials: JC
authors.lastname: Durack
authors.forename: J P
authors.initials: JP
authors.lastname: Erinjeri
authors.forename: C T
authors.initials: CT
authors.lastname: Sofocleous
authors.forename: R H
authors.initials: RH
authors.lastname: Siegelbaum
authors.forename: M
authors.initials: M
authors.lastname: Maybody
authors.forename: S B
authors.initials: SB
authors.lastname: Solomon
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009369:Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D040521:Subcutaneous Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
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