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

Katsuhiro Kobayashi, Peeyush Bhargava, Shanker Raja, Farbod Nasseri, Hassan A. Al-Balas, Darryl D. Smith, Sharad P. George, Meena S. Vij

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Positron emission tomography (PET)/computed tomography (CT) with fluorine 18 fluorodeoxyglucose (FDG) is increasingly used in evaluation of oncology patients. Because PET/CT can demonstrate malignancy before morphologic changes are evident, application of PET/CT information to image-guided biopsy can facilitate early histologic diagnosis and staging. However, because FDG uptake is not specific to cancer, PET/CT findings may raise questions about whether uptake in a lesion is an indication for biopsy. To properly select patients for image-guided biopsy, interventional radiologists should be familiar with the biologic significance of FDG uptake and various causes of false-positive uptake. PET/CT images may also become a source of confusion in the interpretation of biopsy results. Various causes of false-positive and false-negative FDG uptake need to be considered, especially when there is a discrepancy between biopsy results and PET/CT findings. False-negative FDG uptake can result from cancers that are too small to be observed or not FDG avid. False-positive FDG uptake can be due to underlying inflammation from recent treatment. Conversely, complete resolution of FDG uptake in a treated lesion does not necessarily indicate absence of viable cells. When questions about PET/CT findings arise in the context of image-guided biopsy, discussion with experienced nuclear imaging physicians is essential.

Original languageEnglish (US)
Pages (from-to)1483-1501
Number of pages19
JournalRadiographics
Volume32
Issue number5
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

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Image-Guided Biopsy
Biopsy
Neoplasms
Fluorodeoxyglucose F18
Positron Emission Tomography Computed Tomography
Radiologists
Early Diagnosis
Inflammation
Physicians

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Kobayashi, K., Bhargava, P., Raja, S., Nasseri, F., Al-Balas, H. A., Smith, D. D., ... Vij, M. S. (2012). Image-guided biopsy: What the interventional radiologist needs to know about PET/CT. Radiographics, 32(5), 1483-1501. https://doi.org/10.1148/rg.325115159

Image-guided biopsy : What the interventional radiologist needs to know about PET/CT. / Kobayashi, Katsuhiro; Bhargava, Peeyush; Raja, Shanker; Nasseri, Farbod; Al-Balas, Hassan A.; Smith, Darryl D.; George, Sharad P.; Vij, Meena S.

In: Radiographics, Vol. 32, No. 5, 01.09.2012, p. 1483-1501.

Research output: Contribution to journalArticle

Kobayashi, K, Bhargava, P, Raja, S, Nasseri, F, Al-Balas, HA, Smith, DD, George, SP & Vij, MS 2012, 'Image-guided biopsy: What the interventional radiologist needs to know about PET/CT', Radiographics, vol. 32, no. 5, pp. 1483-1501. https://doi.org/10.1148/rg.325115159
Kobayashi, Katsuhiro ; Bhargava, Peeyush ; Raja, Shanker ; Nasseri, Farbod ; Al-Balas, Hassan A. ; Smith, Darryl D. ; George, Sharad P. ; Vij, Meena S. / Image-guided biopsy : What the interventional radiologist needs to know about PET/CT. In: Radiographics. 2012 ; Vol. 32, No. 5. pp. 1483-1501.
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