18F-FDG PET/CT anatomic and metabolic guidance in CT-guided lung biopsies.

Autor: Stefanidis K; Radiology Department, King's College Hospital NHS Foundation Trust, London, UK. Electronic address: kstefanidis@nhs.net., Bellos I; Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece., Konstantelou E; Respiratory Department, Athens Naval Hospital, Athens, Greece., Yusuf G; Radiology Department, King's College Hospital NHS Foundation Trust, London, UK., Hardavella G; 9(th) Department of Respiratory Medicine, 'Sotiria' Athens Chest Diseases Hospital, Athens, Greece., Jacob T; Radiology Department, St George's Hospital, NHS Foundation Trust, London, UK., Goldman A; Radiology Department, St George's Hospital, NHS Foundation Trust, London, UK., Senbanjo T; Radiology Department, Epsom and St Helier, NHS Foundation Trust, London, UK., Vlahos I; Department of Thoracic Radiology, Division of Diagnostic Imaging. University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2024 Feb; Vol. 171, pp. 111315. Date of Electronic Publication: 2024 Jan 14.
DOI: 10.1016/j.ejrad.2024.111315
Abstrakt: Purpose: To evaluate the role of Fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT as a metabolic guide in increasing the accuracy, diagnostic yield and safety of CT-guided percutaneous needle lung biopsy (PNB).
Methods and Materials: Retrospective analysis of 340 consecutive patients with suspicious lung nodules, masses or extensive disease that underwent lung biopsy over a 3-year period. Patients were divided into three groups; those that had PET/CT prior to the biopsy, those that had PET-CT following the biopsy and those who did not undergo PET-CT. Correlation was made with the histopathological result.
Results: 353 PNBs were performed (median lesion size 30 mm, 7-120 mm) with overall diagnostic rate of 83.9 % (95.8 % malignant). Biopsy success rate was 88.8 % with PET-CT pre-PNB, versus 78.9 % of 175 PNB without PET-CT upfront (p < 0.01 Fisher exact test). Correct targeting to PET-CT-maximum activity area (MAA) was present in 87.1 %. Biopsy success rate was 88.8 % for PNBs targeting the PET-CT-MAA region and only 52.8 % for PNBs not targeting the PET-CT-MAA (p < 0.0001). PET-CT pre-PNB had higher rates of PET-CT-MAA targeting compared to PET-CT post PNB (91.0 % v 80.0 %, p = 0.01). The availability of PET-CT before the PNB lead to significantly increased biopsy success rates in patients with a mass (OR:7.01p = 0.004), compared to a nodule (p = 0.498) or multiple nodules (p = 0.163). Patients with a PET-CT pre-PNB underwent fewer PNB passes (mean 2.6 v 3.1, p < 0.0001 Mann Whitney U). Serious complications were less common in PET-CT pre-PNB group (4.5 % v 10.9 %, p < 0.05). Pre-PNB PET-CT performance improvement applied to all 3 radiologists and was greatest for masses and infiltrative abnormalities.
Conclusion: Metabolic information provided by 18F-FDG PET/CT and PNB localisation to the PET-CT maximum activity region is associated with higher diagnostic biopsy rates especially in masses and appears to account for improved performance, less needle passes and complications when available pre-biopsy.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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