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PET/CT 引导下经皮穿刺活检的腹部肿块:使用先前 PET/CT 图像注册的初步经验。

Abdominal masses sampled at PET/CT-guided percutaneous biopsy: initial experience with registration of prior PET/CT images.

机构信息

Department of Radiology, Divisions of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

出版信息

Radiology. 2010 Jul;256(1):305-11. doi: 10.1148/radiol.10090931.

Abstract

PURPOSE

To establish the feasibility of performing combined positron emission tomography (PET)/computed tomography (CT)-guided biopsy of abdominal masses by using previously acquired PET/CT images registered with intraprocedural CT images.

MATERIALS AND METHODS

In this HIPAA-compliant institutional review board-approved study, 14 patients underwent clinically indicated percutaneous biopsy of abdominal masses (mean size, 3.3 cm; range, 1.2-5.0 cm) in the liver (n = 6), presacral soft tissue (n = 3), retroperitoneal lymph nodes (n = 2), spleen (n = 2), and pancreas (n = 1). PET/CT images obtained no more than 62 days (mean, 18.3 days) before the biopsy procedure were registered with intraprocedural CT images by using image registration software. The registered images were used to plan the procedure and help target the masses.

RESULTS

The image registrations were technically successful in all but one patient, who had severe scoliosis. The remaining 13 biopsy procedures yielded diagnostic results, which were positive for malignancy in 10 cases and negative in three cases.

CONCLUSION

PET/CT-guided abdominal biopsy with use of prior PET/CT images registered with intraprocedural CT scans is feasible and may be helpful when fluorine 18 fluorodeoxyglucose-avid masses that are not seen sufficiently with nonenhanced CT are sampled at biopsy.

摘要

目的

通过将术前获取的正电子发射断层扫描(PET)/计算机断层扫描(CT)图像与术中 CT 图像进行配准,来确定对腹部肿块进行 PET/CT 引导下经皮活检的可行性。

材料与方法

在这项符合 HIPAA 标准的机构审查委员会批准的研究中,14 名患者接受了临床推荐的腹部肿块(肝 6 个,直肠前软组织 3 个,腹膜后淋巴结 2 个,脾 2 个,胰腺 1 个)经皮穿刺活检。在活检前不超过 62 天(平均 18.3 天)获取的 PET/CT 图像通过图像配准软件与术中 CT 图像进行了配准。使用配准图像来规划手术并帮助确定肿块的位置。

结果

除了 1 名严重脊柱侧弯的患者外,所有患者的图像配准都取得了技术上的成功。其余 13 例活检均获得了诊断结果,10 例为恶性,3 例为阴性。

结论

使用术前 PET/CT 图像与术中 CT 扫描进行配准的 PET/CT 引导下腹部活检是可行的,当氟 18 氟脱氧葡萄糖(18F-FDG)阳性但非增强 CT 扫描不能充分显示的肿块进行活检时,可能会有所帮助。

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