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

46 Scopus citations

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Image-guided biopsy: What the interventional radiologist needs to know about PET/CT'. Together they form a unique fingerprint.

  • Cite this

    Kobayashi, K., Bhargava, P., Raja, S., Nasseri, F., Al-Balas, H. A., Smith, D. D., George, S. P., & 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