Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, 160012 Chandigarh, India.
Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, 160012 Chandigarh, India.
Diagn Interv Imaging. 2020 Mar;101(3):157-167. doi: 10.1016/j.diii.2019.10.006. Epub 2019 Nov 10.
The purpose of this prospective study was to evaluate the feasibility of positron emission tomography/computed tomography (PET/CT)-guided biopsy of Ga-68 avid lesions using an automated robotic arm and determine the diagnostic yield of this technique.
Patients who underwent Ga-68 labelled tracers imaging followed by PET/CT-guided biopsies of tracer-avid lesions were prospectively included. Biopsies were performed using a dedicated automated-robotic-arm assisted PET/CT-guided biopsy device on the same-day of diagnostic PET/CT-imaging. The tissue samples were retrieved after confirming the position of needle-tip in the target lesion. Procedure-related complications and radiation exposure of the interventionist were recorded. Histopathological reports were reviewed for diagnostic yield.
A total of 25 patients (19 men, six women) with a mean age of 50.8±17.3 (SD) years (range: 17-83 years) were included. The biopsies were performed after PET/CT using Ga-68 DOTANOC (n=16) or Ga-68 PSMA (n=8) and Ga-68 chemokine-analogue (n=1). The biopsy samples were obtained from the liver (n=9), bone (n=8), lymph-nodes (n=3), lung (n=1), pancreas (n=1), anterior mediastinal lesion (n=1), peritoneal-deposit (n=1) and thigh-lesion (n=1). No immediate or delayed procedure-related complications were documented in any patient. PET/CT-guided molecular sampling was technically successful in all the patients. Histopathology revealed malignancies in all the biopsied specimens without the need for repeat sampling or further invasive-diagnostic workup, with a diagnostic yield of 100%. The estimated absorbed-radiation dose was 566.7μSv/year for the interventionist.
PET/CT-guided molecular biopsy using Ga-68 labelled radiotracers is feasible and can be performed safely and accurately with a high-diagnostic yield. It is helpful in accurately staging the disease when tracer-avid isolated distant lesion evident on imaging and highly practical in patients with previous inconclusive sampling.
本前瞻性研究旨在评估使用自动机械臂对 Ga-68 放射性浓聚病灶行正电子发射断层扫描/计算机断层扫描（PET/CT）引导下活检的可行性，并确定该技术的诊断率。
前瞻性纳入了行 Ga-68 标记示踪剂成像后行 PET/CT 引导下 Ga-68 放射性浓聚病灶活检的患者。活检在诊断性 PET/CT 成像当天使用专用自动机械臂辅助 PET/CT 引导下活检设备进行。在确认针尖位于目标病灶后，取出组织样本。记录与操作相关的并发症和介入医生的辐射暴露情况。回顾组织病理学报告以评估诊断率。
共纳入 25 例患者（19 例男性，6 例女性），平均年龄 50.8±17.3（标准差）岁（范围：17-83 岁）。使用 Ga-68 DOTANOC（n=16）或 Ga-68 PSMA（n=8）和 Ga-68 趋化因子类似物（n=1）行 PET/CT 后进行了活检。活检样本取自肝脏（n=9）、骨骼（n=8）、淋巴结（n=3）、肺（n=1）、胰腺（n=1）、前纵隔病变（n=1）、腹膜沉积物（n=1）和大腿病变（n=1）。所有患者均未记录到即刻或延迟的与操作相关的并发症。所有患者的 PET/CT 引导下分子采样均获得成功。组织病理学显示所有活检标本均为恶性肿瘤，无需再次取样或进一步的有创性诊断性检查，诊断率为 100%。介入医生的估计吸收辐射剂量为 566.7μSv/年。
使用 Ga-68 标记放射性示踪剂行 PET/CT 引导下分子活检是可行的，并且可以安全、准确地进行，具有较高的诊断率。当影像学显示有远处孤立的、示踪剂浓聚的病灶且需要准确分期疾病时，该方法很有帮助，并且对于之前取样结果不确定的患者非常实用。
