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18 FDG-PET/CT computer-assisted biopsies for suspected persistent or recurrent malignant skull base disease
Patrick Dubach1, Thiago Oliveira-Santos, Stefan Weber
1Department of ENT, Head and Neck Surgery, Inselspital, University of Bern, 3010, Bern, Switzerland; BMBF-Innovation Center Computer Assisted Surgery ICCAS, University of Leipzig, 04103, Leipzig, Germany.
Abstract:
Background: FDG-PET/CT is increasingly used for the evaluation of regional or distant metastasis in head and neck oncology. However, positive PET findings lack specificity, which is especially challenging for localized disease at the skull base. Methods: An optically tracked navigation system for multimodal image-guided biopsies was tested to evaluate PET-positive skull base lesions between 2009 and 2013. Results: FDG-PET/CT navigated biopsies of patients with suspected persistence or recurrence of carcinoma (sinonasal, n=3; nasopharyngeal, n=1; adenocarcinoma, n=2; and carcinoma of unknown primary origin, n=1) have been safely performed. Histology confirmed local persistent or recurrent malignant disease (n=5), radio-osteonecrosis (n=1) and super-infection (n=1). Conclusions: In the follow-up of tumor patients, FDG-PET/CT-navigated biopsies are a valid tool to evaluate PET-positive skull base lesions. This is an especially useful technique if functional anomalous areas in FDG-PET/CT do not cause structural alterations in MRI/CT, and if endoscopic visualization is impossible because of post-treatment alterations. Head Neck, 2014.
