Abstract
Objective: To evaluate the clinical significance of percutaneous puncture biopsy guided by fused and 3D-reconstructed Positron-Emission Tomography (PET)/Computed Tomography (CT) images in diagnosing deep lesions.
Methods: According to the CT morphological information obtained from 47 patients who need to undertake percutaneous needle biopsy after PET/CT examination, two associate chief physicians selected the lesion with SUVmax >2.5 as the target spot of the surgery. The two operators performed a first CT scan of the lesion to define an optimal puncture path. After CT scan, images with a thickness of 1.5 mm were transmitted to the processing center, then fused and 3D-reconstructed with PET images. When the target lesion area was clearly identified and selected, an 18G biopsy needle was threaded through the trocar to incise the tissues inside the lesion. Pathological examination of the target lesion tissue was accomplished.
Results: Using images obtained from the same instrument, location, shape and 2-[18F]-fluoro-2- deoxy-D-glucose (FDG) uptake of deep lesions were clearly and dimensionally displayed, thus the biopsy needle was precisely guided through its pathway to the hypermetabolic lesion. All percutaneous puncture biopsies were successfully accomplished (100%), with an accuracy of 97.9% (46/47) and an average surgical duration of 17.3±9.5 min. All post-operative pathological examinations achieved a precise diagnosis.
Conclusions: With the guidance of fused and 3D-reconstructed PET/CT images, the lesion could be precisely identified. Hence, percutaneous needle biopsy obtained from morphology-guided to metabolism-guided techniques has a clear significance in clinical practice.
Keywords: PET/CT, fusion, 3D-reconstructed, needle biopsy, patients, FDG.
Graphical Abstract
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