Fluorodeoxyglucose-PET/Computed Tomography–Guided Biopsy

Real-time intraprocedural18F-FDG PET/CT-guided biopsy using automated robopsy arm (ARA) in the diagnostic evaluation of thoracic lesions with prior inconclusive biopsy results: initial experience from a tertiary health care centre

“…10,13,14 18 F-FDG PET/CT has the distinct advantage of metabolic characterization of visualized tissues and thus has a potential to accurately differentiate viable from non-viable tissues. 15,16 This property of 18 F-FDG PET/CT could reduce inconclusive biopsy results by specifically targeting areas of viability showing 18 F-FDG uptake. Also, added advantage of metabolic characterization by 18 F-FDG PET/CT lies in the fact that it can guide the lesion to be biopsied when more than one lesion is present and that it can identify early pathological changes before obvious morphological changes appear on CI.…”

“…15,16 This property of 18 F-FDG PET/CT could reduce inconclusive biopsy results by specifically targeting areas of viability showing 18 F-FDG uptake. Also, added advantage of metabolic characterization by 18 F-FDG PET/CT lies in the fact that it can guide the lesion to be biopsied when more than one lesion is present and that it can identify early pathological changes before obvious morphological changes appear on CI. 17,18 Benefits of 18 F-FDG PET/CT in guiding biopsies have been explored recently, but many of these studies were performed utilizing previously acquired PET/CT images to guide the intraprocedural needle placement through visual or software-based fusion.…”

“…Also, added advantage of metabolic characterization by 18 F-FDG PET/CT lies in the fact that it can guide the lesion to be biopsied when more than one lesion is present and that it can identify early pathological changes before obvious morphological changes appear on CI. 17,18 Benefits of 18 F-FDG PET/CT in guiding biopsies have been explored recently, but many of these studies were performed utilizing previously acquired PET/CT images to guide the intraprocedural needle placement through visual or software-based fusion. [19][20][21] Although this approach is more effective than the conventional technique, it is not devoid of errors due to technical or procedure-related logistics (e.g.…”

“…differences in patient positioning etc). 18 In the present study, we evaluated the diagnostic utility of realtime intraprocedural 18 F-FDG PET/CT guidance for sampling thoracic masses using an automated robopsy arm (ARA) in patients with a prior inconclusive CI-guided needle aspiration or core biopsy result.…”

“…The biopsy procedure was performed in these patients after a time delay of 4-6 h with an intent to reduce the radiation exposure to the operator. In patients with a previous PET/CT study, a lower dose of 18 F-FDG (111-148 MBq) was administered and biopsy procedure was performed, 40-60 min later.…”