DOI: 10.1007/s00259-018-4133-xPages: 1-10

Diagnostic performance of real-time robotic arm-assisted 18F-FDG PET/CT-guided percutaneous biopsy in metabolically active abdominal and pelvic lesions

1. Post Graduate Institute of Medical Education and Research, Department of Nuclear Medicine and PET/CT

2. Post Graduate Institute of Medical Education and Research, Department of Pathology

3. Post Graduate Institute of Medical Education and Research, Department of Hemato-Oncology

4. Post Graduate Institute of Medical Education and Research, Department of Surgery

5. Post Graduate Institute of Medical Education and Research, Department of Rheumatology

Correspondence to:
Bhagwant Rai Mittal
Tel: +911722756722
Email: brmittal@yahoo.com

Close

Abstract

Purpose

To evaluate the feasibility and diagnostic performance of 18F-FDG PET/CT-guided biopsy of abdominal and pelvic lesions with automated robotic arm (ARA) assistance.

Methods

This prospective study included 114 patients (75 men, 39 women; mean age 51.3 ± 14.7 years, range: 18–90 years) who underwent PET/CT-guided biopsy of FDG-avid abdominal and pelvic lesions from October 2014 to December 2017. Of these patients, 54 had a prior inconclusive CT-guided biopsy. The biopsies were done with ARA assistance, and a real-time sample was obtained after confirming the position of the needle tip within the target lesion on PET/CT. Histopathology reports were reviewed to evaluate the diagnostic performance of the procedure. Clinical or imaging follow-up was done to confirm negative results.

Results

The lesions were successfully targeted in 110 of the 114 patients (96.5%) and yielded a pathological diagnosis. Pathological diagnoses were confirmed in 50 of the 54 patients with a prior inconclusive biopsy. Of the 110 lesions, 82 were malignant, 20 were benign, and 8 showed minimal residual FDG uptake at the end of treatment and had no active disease even on clinical and imaging follow-up of at least 3 months. Findings were true-positive in 102 lesions, false-positive in none, true-negative in eight and false-negative in four. The procedure showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 96.2%, 100%, 100%, 66.7 and 96.5%, respectively. No immediate complications or delayed life-threatening events were observed.

Conclusion

Percutaneous biopsy of metabolically active abdominal and pelvic lesions with ARA assistance is a technically feasible, safe and accurate method for pathological diagnosis with high diagnostic performance. PET-guided biopsy is highly practical and useful in patients, especially in those with a previous inconclusive biopsy.

To access the full text, please Sign in

If you have institutional access, please click here

  • Accepted: Aug 12, 2018
  • Online: Aug 30, 2018

Article Tools

eanm
EJNMMI Ad