Initial Experience of Utilizing Real-Time Intra-Procedural PET/CT Biopsy

Area of Science:

• Nuclear Medicine
• Radiology
• Interventional Radiology

Background:

• Nonreal-time PET/CT biopsies rely on co-registration of prior PET scans with intra-procedural CT.
• A need exists for improved biopsy guidance, especially for lesions lacking clear anatomical definition on CT.

Purpose of the Study:

• To report the initial experience and feasibility of performing real-time intra-procedural PET/CT-guided biopsies.
• To evaluate the effectiveness and safety of this novel biopsy technique.

Main Methods:

• Four patients with concerning lesions (mesenteric mass, bone lesions) underwent real-time PET/CT-guided biopsy.
• A molecular probe (18F-FDG or NaF18) was administered, followed by limited-field PET/CT imaging for lesion localization.
• Biopsies were performed using real-time PET/CT guidance.

Main Results:

• Histopathology confirmed malignancy in 50% of lesions and benign findings in 50%.
• The biopsy results directly influenced and changed management in all four patients.
• The study reported a 0% complication rate, indicating a safe procedure.

Conclusions:

• Real-time intra-procedural PET/CT-guided biopsies require no specialized software or hardware.
• This technique can enhance diagnostic yield, particularly for lesions without CT-visible abnormalities.
• Real-time PET/CT biopsy may offer superior accuracy compared to conventional biopsy methods.