Diagnostic accuracy of positron emission tomography/computed tomography-driven biopsy for the diagnosis of lymphoma

Abstract

Introduction Biopsy of affected tissue is required for lymphoma diagnosis and to plan treatment. Open incisional biopsy is traditionally the method of choice. Nevertheless, it requires hospitalization, availability of an operating room, and sometimes general anesthesia, and it is associated with several drawbacks. Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) can be potentially used to drive biopsy to the most metabolically active area within a lymph node or extranodal masses. Methods A study of diagnostic accuracy was conducted to assess the performance of a PET-driven needle biopsy in patients with suspect active lymphoma. Results Overall, 99 procedures have been performed: three (3.0%) were interrupted because of pain but were successfully repeated in two cases. Median SUVmax of target lesions was 10.7. In 84/96 cases, the tissue was considered adequate to formulate a diagnosis (diagnostic yield of 87.5%) and to guide the following clinical decision. The target specimen was a lymph node in 60 cases and an extranodal site in 36. No serious adverse events occurred. The sensitivity of this procedure was 96%, with a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 75%. Conclusion Patients can benefit from a minimally invasive procedure which allows a timely and accurate diagnosis of lymphoma at onset or relapse.

Can the BMI-based dose regimen be used to reduce injection activity and to obtain a constant image quality in oncological patients by 18F-FDG total-body PET/CT imaging?

“…F-18-fluorodeoxyglucose Positron emission tomography/Computed Tomography ( 18 F-FDG PET/CT) is being widely used in tumor diagnosis, staging, restaging, and response evaluation. Meanwhile, this hybrid imaging modality has shown the potential value in prognosis prediction, image-guided biopsy, providing both anatomic and functional information for clinical management [1][2][3][4][5]. The total-body PET/CT, with an increased geometric overage to encompass the entire body, can dramatically improve the PET sensitivity by a factor of about 40 over existing PET scanners for imaging the entire body.…”

Clinical Role of Upfront F-18 FDG PET/CT in Determining Biopsy Sites for Lung Cancer Diagnosis

“…Yoo et al showed that PET/CT contributes to the practical determination of biopsy sites in patients with suspected malignancy, regardless of the determination of primary or metastatic lesions [13]. CT-and US-guided core needle biopsies have reported diagnostic accuracy ranging from 87.5% to 100% when assessing various sites in patients suspected of malignancy, including breast cancer, colorectal cancer, sarcoma, melanoma, prostate cancer, and lymphoma [34,35]. However, to date, few studies have been conducted on the impact of PET/CT in determining biopsy sites for patients with lung cancer.…”

Performance of Ultrasound-Guided Core Biopsy Driven by FDG-avid Supraclavicular Lymph Nodes in Patients With Suspected Lung Cancer

“…Finally, but most importantly, biopsy driven by FDG-avid lesions have demonstrated a high diagnostic yield in various type of changes including thoracic, abdominal, bone, muscle, and breast lesions ( 10 , 11 ). Because FDG avidness in malignant lesions represents the existence of metabolically active tumor cells, sampling of FDG-avid lesions will be more likely to yield representative material for molecular analysis ( 12 , 13 ).…”