SPECT/CT-guided percutaneous transthoracic needle biopsy of thoracic masses

Abstract

Objective To investigate a real-time imaging guided percutaneous transthoracic needle biopsy (PTNB) for thoracic masses with SPECT/CT. Methods From March to June 2016, a total of 12 patients (7 males, 5 females; average age: (59.2±13.2) years) with thoracic lesions suspicious for malignancy underwent 99Tcm-methoxyisobutylisonitrile (MIBI) SPECT/CT-guided PTNB. The hot spot areas were chosen from the thorax 99Tcm-MIBI SPECT/CT images as the sampling targets. Subsequent guiding CT scans were repeatedly fused with the prior SPECT images to realize the real-time guiding of the biopsy needle puncture step by step, until reaching to the target margin. Masses were sampled after confirming that the needle tips reached planned areas. Pathological results, total time of examination, time of PTNB procedure, complication, CT radiation dosage were recorded. Results Based on 99Tcm-MIBI SPECT/CT results, biopsies targeted the most suspicious areas within lesions. All biopsy procedures yielded diagnostic results. Eleven patients had positive results of malignancy, and 1 patient with inflammation. There were no severe complications. Total time of examination was (74.3±10.4) min, and (33.5±9.1) min for PTNB. Radiation dosage of CT was (6.1±1.7) mSv, 36% of which was caused by CT-guiding ((2.2±1.0) mSv). Conclusion Multimodal of SPECT/CT fusion imaging is useful for thorax biopsy planning and guiding, and can increase overall performance of safety and feasibility. Key words: Thoracic neoplasms; Biopsy, needle; Tomography, emission-computed, single-photon; Technetium Tc 99m sestamibi