Measurement of the Radioactivity of PET/CT-Guided Biopsy Specimen: Is it Helpful to Confirm the Sampling from a Viable Region of the Tumor and the Nature of the Lesion?

OBJECTIVE

radioactivity measurement of positron emission tomography/computed tomography (PET/CT)-guided biopsy tissue specimen to check the viable tumor sampling and predict the nature of the biopsied lesion.

MATERIALS AND METHODS

We prospectively evaluated the retrieved tissue specimens during PET/CT-guided biopsies for the presence of radioactivity. The qualitative radioactivity was measured by acquiring PET/CT images of the specimen. For quantitative analysis, a multichannel-analyzer (MCA) was used, and a counting-factor (CF) in counts/mCi.mm was calculated based on background-corrected net-counts, tissue-volume (mm), and exponential tracer-activity during biopsy (mCi). The CF-values were compared with the 2-(fluorine-18) fluoro-2-deoxy-D-glucose-avidity in the target lesion and correlated with the histopathology.

RESULTS

A total of 49 patients (30 males) aged 51.8 ± 17.8 years were recruited for the biopsy, and radioactivity was measured. All the specimens revealed the presence of radioactivity on PET/CT images of the specimens and MCA counting. The mean CF-values were 17.2 ± 15.6 counts/mCi.mm. One sample had meager counts with a CF-value of 0.162 and was subjected to re-biopsy after repositioning the coaxial needle to the hypermetabolic site. Pathological diagnosis was established in all the patients (malignancy-29, benign-20). The CF-values were significantly higher in malignant lesions than benign (21.45 ± 18.05 vs. 10.76 ± 8.96 counts/mCi.mm, = 0.025). CF-values and maximum standardized uptake value had a significant correlation (Pearson's = 0.457, = 0.001).

CONCLUSION

The measurement of the radioactivity of retrieved tissue specimens during PET/CT-guided biopsy helps to confirm the sampling from viable region and a highly practical approach to avoid erroneous sampling of a lesion with a large necrotic area. It is also helpful in predicting the nature of the biopsied lesion before the histopathological analysis.