Purandare Nilendu C, Kulkarni Aniruddha V, Kulkarni Suyash S, Roy Diptiman, Agrawal Archi, Shah Sneha, Rangarajan Venkatesh
Departments of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Mumbai, India.
Nucl Med Commun. 2013 Mar;34(3):203-10. doi: 10.1097/MNM.0b013e32835c5a57.
To study whether the metabolic information provided by a prior PET/computed tomography (CT) scan can add valuable information and an incremental benefit while performing image-guided biopsies.
Fluorine-18 fluorodeoxyglucose (F-FDG) PET/CT findings of 112 patients were available before biopsy and were considered for analysis. Biopsies were performed using standard techniques only after the needle tip was confirmed to be in the portion of the lesion corresponding to the hypermetabolic area seen on PET. This was achieved by visual coregistration and also by software registration algorithms that registered the intraprocedural CT images with the preselected PET/CT data. Only those biopsies for which a definitive histopathological diagnosis could be made were considered 'diagnostic'. Cases in which PET/CT added an incremental value were divided into three categories.
A total of 112 patients (66 male and 46 female, age range 16-74 years) underwent a biopsy based on PET findings. The biopsy sites were as follows: lung, 54; lymph nodes, 27; bone, 12; and soft-tissue masses/deposits, 19. Out of the 112 biopsies, an incremental benefit was seen overall in 53 patients (47.3%): in 40.7% (22/54) of patients who underwent lung biopsies, 44.4% (12/27) of those who underwent lymph node biopsies, 66.6% (8/12) of those who underwent bone biopsies and 57.8% (11/19) of those who underwent soft-tissue biopsies. Out of the cases that showed an incremental benefit, the highest number (30) belonged to the category in which the biopsy sample was obtained from the focal hypermetabolic portion of the apparently larger morphological lesion seen on CT.
PET/CT data coregistered with intraprocedural CT images can guide needle placement in the viable portion of the lesion, thus increasing the chances of achieving a definitive diagnosis. This approach can offer a significant incremental benefit while performing image-guided biopsies.
研究在进行图像引导活检时，先前的正电子发射断层扫描/计算机断层扫描（PET/CT）所提供的代谢信息是否能增加有价值的信息及额外益处。
112例患者在活检前有氟-18氟脱氧葡萄糖（F-FDG）PET/CT检查结果并纳入分析。仅在确认针尖位于PET上显示的高代谢区域对应的病变部位后，才使用标准技术进行活检。这通过视觉配准以及将术中CT图像与预先选定的PET/CT数据进行配准的软件算法来实现。仅那些能做出明确组织病理学诊断的活检被视为“诊断性”活检。PET/CT增加额外价值的病例分为三类。
总共112例患者（66例男性和46例女性，年龄范围16 - 74岁）基于PET检查结果接受了活检。活检部位如下：肺，54例；淋巴结，27例；骨，12例；软组织肿块/沉积物，19例。在112例活检中，总体上53例患者（47.3%）有额外益处：肺活检患者中有40.7%（22/54）、淋巴结活检患者中有44.4%（12/27）、骨活检患者中有66.6%（8/12）、软组织活检患者中有57.8%（11/19）。在显示有额外益处的病例中，数量最多的（30例）属于从CT上看似较大形态学病变的局灶性高代谢部分获取活检样本的类别。
与术中CT图像配准的PET/CT数据可将针引导至病变的活性部分，从而增加获得明确诊断的机会。这种方法在进行图像引导活检时可提供显著的额外益处。
