PET/CT-Guided Biopsy of Suspected Lung Lesions Requires Less Rebiopsy Than CT-Guided Biopsy Due to Inconclusive Results

Cerci, Juliano Júlio; Bogoni, Mateos; Cerci, Rodrigo; Masukawa, Margaret; Neto, Carlos Cunha Pereira; Krauzer, Cassiano; Fanti, Stefano; Sakamoto, Danielle Giacometti; Barreiros, Renan B.; Nanni, Cristina; Vítola, João V.

doi:10.2967/jnumed.120.252403

Cited by 12 publications

(17 citation statements)

References 23 publications

(19 reference statements)

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“…In our study, we enrolled masses or consolidation larger than 3 cm. In these cases, PET/CT images were necessary to guide biopsy [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we enrolled masses or consolidation larger than 3 cm. In these cases, PET/CT images were necessary to guide biopsy [17]. Interestingly, even though CNB of lung lesions is a high-risk procedure, but no severe complications developed.…”

Section: Discussionmentioning

confidence: 99%

“…The CT-guided biopsy method was consisted with our previous studies. [ 15 , 16 ] The severity of procedural complications was evaluated according to the Society of Interventional Radiology Standards of Practice Committee classification of complications [ 17 ], and procedure duration (defined as the interval time between the initial scout image and the end of the final CT scan) was also recorded. In addition, a repeat biopsy was considered when the patient’s clinical condition was obviously inconsistent with initial biopsy results (two patients) or when chemotherapy or targeted therapy regimens need to be adjusted (twenty patients).…”

Section: Methodsmentioning

confidence: 99%

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Improving CT-guided transthoracic biopsy diagnostic yield of lung masses using intraprocedural CT and prior PET/CT fusion imaging

Lin

et al. 2022

BMC Pulm Med

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Objective The purpose of this study was to evaluate the usefulness of intraprocedural CT and prior PET/CT fusion imaging in improving the diagnostic yield of CT-guided transthoracic core-needle biopsy (CNB) in lung masses. Methods In total, 145 subjects with lung masses suspicious for malignancy underwent image-guided transthoracic CNB. According to imaging modality the subjects were divided into two groups. PET/CT images obtained no more than 14 days before the biopsy were integrated with intraprocedural CT images. The integrated or fused images were then used to plan the puncture sites. The clinical characteristics, diagnostic yield of CNB, diagnostic accuracy rate, procedure-related complications and procedure duration were recorded and compared between the two groups. Final clinical diagnosis was determined by surgical pathology or at least 6-months follow-up. The diagnostic accuracy of CNB was obtained by comparing with final clinical diagnosis. Results 145 subjects underwent CNB with adequate samples, including 76 in fusion imaging group and 69 in routine group. The overall diagnostic yield and diagnostic accuracy rate were 80.3% (53/66), 82.9% (63/76) for fusion imaging group, 70.7% (41/58), 75.4% (52/69) for routine group, respectively. In addition, the diagnostic yield for malignancy in fusion imaging group (98.1%, 52/53) was higher than that in routine group (81.3%, 39/48). No serious procedure-related complications occurred in both two groups. Conclusion CNB with prior PET/CT fusion imaging is particularly helpful in improving diagnostic yield and accurate rate of biopsy in lung masses, especially in heterogeneous ones, thus providing greater potential benefit for patients.

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“…In our study, we enrolled masses or consolidation larger than 3 cm. In these cases, PET/CT images were necessary to guide biopsy [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Improving CT-guided transthoracic biopsy diagnostic yield of lung masses using intraprocedural CT and prior PET/CT fusion imaging

Lin

et al. 2022

BMC Pulm Med

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“…Ceci et al 25 recently reported how PET/CT-guided biopsy of lung lesions led to fewer inconclusive biopsies than CT-guided biopsy, confirming how the 18 F-FDG uptake cover a key role in the potential histological characterization. Another recent report by Caruso et al 26 point out the ability of Radiomics CT-texture analysis in differentiating malignant from benign lung nodules with low FDG uptake, enhancing the importance of radiological heterogeneity beyond FDG PET/CT and lung biopsy. In this scenario, future studies are needed to assess if Radiomics features may give more information about the biopsy outcome prediction.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield of CT-guided lung biopsies: how can we limit negative sampling?

Tipaldi

Ronconi

Krokidis

et al. 2021

The British Journal of Radiology

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Objectives: To investigate whether lesion imaging features may condition the outcome of CT-guided lung biopsy (CTLB) and to develop a scoring system of biopsy outcome prediction. Methods: This is a single center retrospective study on 319 CTLBs that were performed in 319 patients (167 males/152 females, mean age 68 ± 12.2). Uni- and multivariate analysis were performed aiming to assess the imaging features that are likely to be correlated to a negative biopsy outcome and patients were stratified in groups accordingly. Results: Technical success was 100%. 78% of the biopsies (250/319) led to a concrete histology report (218 malignant/32 benign). The remaining lesions led to concrete histology at a second attempt that occurred on a later time. Multivariate analysis revealed increased risk of inconclusive result for nodules with low fludeoxyglucose uptake [odds ration (OR) = 2.64, 95% confidence interval (CI) 1.4–4.97; p = 0.003], for nodules with diameter smaller than 18 mm (OR = 2.03, 95% CI 1.14–3.62; p = 0.017) and for nodules that are located in one of the lung bases (OR = 1.96, 95% CI 1.06–3.62; p = 0.033). Three different groups of patients were identified accordingly with low (<30%), medium (30–50%) and high (>50%) probability of obtaining an inconclusive biopsy sample. Conclusion: This study confirms that percutaneous CT-guided biopsy in nodules that are either small in diameter or present low positron emission tomography-fludeoxyglucose uptake or are in one of the lung bases may lead to inconclusive histology. This information should be factored when planning percutaneous biopsies of such nodules in terms of patient informed consent and biopsy strategy. Advances in knowledge: Inconclusive histology after lung biopsy may be subject to factors irrelevant to technical success. Lung biopsy histology outcomes may be predicted and avoided after adequate planning.

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“…Percutaneous lung needle biopsy can be guided by different imaging techniques, such as CT [ 2 ], fluoroscopy CT [ 12 ], cone beam CT [ 13 ], positron emission tomography (PET)-CT [ 14 ], or ultrasound in case of superficially located lesions [ 15 ]. The choice of the imaging technique depends on its availability, lesion type and location, patient’s collaboration, and operator’s preferences [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Dual-layer spectral CT fusion imaging for lung biopsies: more accurate targets, diagnostic samplings, and biomarker information?

et al. 2022

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The increasingly widespread use of computed tomography (CT) has increased the number of detected lung lesions, which are then subjected to needle biopsy to obtain histopathological diagnosis. Obtaining high-quality biopsy specimens is fundamental for diagnosis and biomolecular characterisation that guide therapy decision-making. In order to obtain samples with high diagnostic potential, fusion imaging techniques, such as fusion between positron emission tomography and CT, have been introduced to target the biopsy where there more viable neoplastic cells can be sampled. Nowadays, dual-layer spectral CT represents a novel technology enabling an increased tissue characterisation. In particular, Z-effective images, i.e., colour-coded images based on the effective atomic number of tissue components, provide a higher level of discrimination than usual imaged based on x-ray attenuation in Hounsfield units and offer the potential of a better tissue characterisation. Our hypothesis is based on the future use of data provided by spectral CT, in particular by Z-effective images, as a guide for appropriate biopsy sampling for histopathological and biomolecular characterisation in the era of patient tailored-therapy.

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PET/CT-Guided Biopsy of Suspected Lung Lesions Requires Less Rebiopsy Than CT-Guided Biopsy Due to Inconclusive Results

Abstract: Title: PET/CT guided biopsy of suspected lung lesions requires less rebiopsy than CT guided biopsy due to inconclusive results.

Cited by 12 publications

References 23 publications

Improving CT-guided transthoracic biopsy diagnostic yield of lung masses using intraprocedural CT and prior PET/CT fusion imaging

Improving CT-guided transthoracic biopsy diagnostic yield of lung masses using intraprocedural CT and prior PET/CT fusion imaging

Diagnostic yield of CT-guided lung biopsies: how can we limit negative sampling?

Dual-layer spectral CT fusion imaging for lung biopsies: more accurate targets, diagnostic samplings, and biomarker information?

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