PET/CT-guided versus CT-guided percutaneous core biopsies in the diagnosis of bone tumors and tumor-like lesions: which is the better choice?

Min-Hao Wu,Ling-Fei Xiao,Yan Chen,Huo-Wen Liu,Xiao-Xiao Liang,Zhi-Qiang Yang,Zhou-Ming Deng,Jun Lei

doi:10.1186/s40644-019-0253-1

Min-Hao Wu, Ling-Fei Xiao + Show 6 more

Open Access

https://doi.org/10.1186/s40644-019-0253-1

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Abstract

ObjectiveThe present study aimed to evaluate the diagnostic performance and safety of PET/CT-guided percutaneous core bone biopsy and to compare the PET/CT-guided method to conventional CT-guided percutaneous core biopsies to diagnose Chinese patients with bone tumors and tumor-like lesions.MethodsData for 97 patients with bone tumors and tumor-like lesions diagnosed by percutaneous core bone biopsy from February 2013 to November 2018 were retrospectively analyzed. The study included 42 cases in the PET/CT group and 55 cases in the CT alone group. The diagnostic performance, cost and complications associated with the intervention were compared between the two groups. All patients were eventually confirmed to have bone tumors and tumor-like lesions according to surgical pathology findings.ResultsThere were no significant differences in patient characteristics (P > 0.05). For the patients in the PET/CT group, the overall diagnostic yield of the initial biopsies and the diagnostic accuracy derived from the surgically proven cases were both 97.62%, which was significantly higher than the values in the CT group during the same period (P < 0.05). No major biopsy-related complications (e.g., serious bleeding or tumor dissemination) occurred before, during, or after the intervention. Therefore, no significant difference was observed between the two groups with regard to the complication rate (P > 0.05).ConclusionCompared with CT-guided percutaneous bone biopsy, PET/CT-guided percutaneous bone biopsy is an effective and safe alternative with high diagnostic performance in the evaluation of hypermetabolic bone lesions to diagnose bone tumors and tumor-like lesions.

Highlights

Traditional computed tomography (CT)-guided percutaneous core-needle biopsy is the gold standard diagnostic procedure for patients with newly developed bone lesion s[1]
The inclusion criteria were as follows: (1) treatment by open surgery with tumor resection after biopsy; (2) primary percutaneous core-needle biopsy was performed at our center; (3) 18FFDG Positron emission tomography/computed tomography (PET/CT)-guided or CT-guided biopsy was performed as part of the initial diagnostic intervention before open surgery; and (4) final surgical histopathology results were confirmed as bone tumors or tumor-like lesions
Clinical characteristics During the study period, 97 patients who were diagnosed with bone tumors or tumor-like lesions were eventually enrolled in this retrospective study, including 42 treated by PET/CT-guided biopsy and 55 treated by CT-guided biopsy

Summary

Introduction

Traditional computed tomography (CT)-guided percutaneous core-needle biopsy is the gold standard diagnostic procedure for patients with newly developed bone lesion s[1]. PET/CT combines the anatomic information from CT with the metabolic characterization from PET; the use of PET guidance improves target selection and allows a direct biopsy needle trajectory to the hypermetabolic region of active isolated or multifocal (≥2) bone lesions, which is more likely to yield a positive biopsy result [16]. Whether PET/CT-guided biopsy can replace routine CT-guided biopsy to diagnose bone neoplasms remains controversial [21]. The purpose of this study was to compare the diagnostic yield, accuracy, cost and safety of PET/CT-guided and CT-guided percutaneous core biopsies in diagnosing bone tumors and tumor-like lesions during the same period

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