Image-guided biopsy: what the interventional radiologist needs to know about PET/CT.

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Fluorine 18 fluorodeoxyglucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) is vital in oncology for early malignancy detection.
• PET/CT imaging can reveal cancerous changes before morphological alterations are apparent.

Purpose of the Study:

• To guide interventional radiologists in selecting patients for image-guided biopsy based on PET/CT findings.
• To clarify the biologic significance of FDG uptake and its potential for false-positive results.

Main Methods:

• Review of PET/CT imaging principles in oncology.
• Analysis of causes for false-positive and false-negative FDG uptake.
• Consideration of discrepancies between PET/CT and biopsy results.

Main Results:

• FDG uptake is not specific to cancer, leading to potential false positives.
• False negatives can occur with small or non-FDG avid tumors.
• Inflammation from treatment can cause false-positive FDG uptake.
• Complete resolution of FDG uptake does not guarantee absence of viable cancer cells.

Conclusions:

• Interventional radiologists must understand FDG uptake's biologic significance and false-positive causes for appropriate biopsy selection.
• Discrepancies between PET/CT and biopsy necessitate consultation with nuclear imaging physicians.
• Careful interpretation of PET/CT is essential to avoid confusion in biopsy result analysis.