Federico Fontana1,2, Filippo Piacentino1, Anna Maria Ierardi3,4, Gianpaolo Carrafiello3,4, Andrea Coppola5, Alessandra Muollo6, Alessandro Beneventi7, Chiara Floridi8, Andrea Selenito Imperatori2,9, Giulio Carcano2,10, Massimo Venturini1,2. 1. Diagnostic and Interventional Radiology Department, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Via Guicciardini, 9, 21100, Varese, Italy. 2. Università degli Studi dell'Insubria, Varese, Italy. 3. Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy. 4. Università degli Studi di Milano, Milan, Italy. 5. Diagnostic and Interventional Radiology Department, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Via Guicciardini, 9, 21100, Varese, Italy. coppola.andrea.mg@gmail.com. 6. Radiology Department, Ospedale di Legnano, ASST Ovest Milanese, Legnano, MI, Italy. 7. Diagnostic and Interventional Radiology Department, Ospedale Sant'Anna, ASST Lariana, Como, Italy. 8. Università Politecnica delle Marche, Ancona, Italy. 9. Thoracic Surgery Department, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Varese, Italy. 10. Surgery Department, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Varese, Italy.
Abstract
PURPOSE: To establish the feasibility of performing percutaneous biopsy of lung lesions guided by fusion PET/CT-CBCT and to evaluate whether the metabolic information provided by a prior PET/CT scan add incremental benefits for diagnosis. METHODS: We retrospectively reviewed data from 180 patients who underwent CBCT-guided lung biopsy (group 1-90 cases) or PET/CT-CBCT fusion-guided lung biopsy (group 2-90 cases). Technical and clinical success was calculated. We also evaluated the agreement between biopsy and definitive histology and the possibility to carrying out immunehistochemical and molecular biology analyses. RESULTS: Technical success was achieved in 84/90 (93.3%) cases for group 1 and 89/90 (98.9%) for group 2 cases (p 0.054). Clinical success was achieved in 80/94 (95.2%) cases for group 1 and 88/89 (98.9%) cases for group 2. Sensitivity, specificity, positive and negative predictive values and accuracy rate were, respectively, 94.5%, 100.0%, 100.0%, 73.3% and 95.2% for group 1 and 98.6%, 100.0%, 100.0%, 94.4% and 98.9% for group 2 (p 0.167). Agreement between biopsy and definitive histology was reached in 85.7% for group 1 and in 96.2% for group 2 (p 0.211). Immunohistochemical and molecular biology investigations were possible in 66.7% for group 1 and in 77.0% for group 2 (p 0.297). No major complication occurred. CONCLUSIONS: PET/CT-CBCT-guided lung biopsy is a feasible technique. In our retrospective case series, we found a higher clinical success rate, but no statistical difference was found.
PURPOSE: To establish the feasibility of performing percutaneous biopsy of lung lesions guided by fusion PET/CT-CBCT and to evaluate whether the metabolic information provided by a prior PET/CT scan add incremental benefits for diagnosis. METHODS: We retrospectively reviewed data from 180 patients who underwent CBCT-guided lung biopsy (group 1-90 cases) or PET/CT-CBCT fusion-guided lung biopsy (group 2-90 cases). Technical and clinical success was calculated. We also evaluated the agreement between biopsy and definitive histology and the possibility to carrying out immunehistochemical and molecular biology analyses. RESULTS: Technical success was achieved in 84/90 (93.3%) cases for group 1 and 89/90 (98.9%) for group 2 cases (p 0.054). Clinical success was achieved in 80/94 (95.2%) cases for group 1 and 88/89 (98.9%) cases for group 2. Sensitivity, specificity, positive and negative predictive values and accuracy rate were, respectively, 94.5%, 100.0%, 100.0%, 73.3% and 95.2% for group 1 and 98.6%, 100.0%, 100.0%, 94.4% and 98.9% for group 2 (p 0.167). Agreement between biopsy and definitive histology was reached in 85.7% for group 1 and in 96.2% for group 2 (p 0.211). Immunohistochemical and molecular biology investigations were possible in 66.7% for group 1 and in 77.0% for group 2 (p 0.297). No major complication occurred. CONCLUSIONS: PET/CT-CBCT-guided lung biopsy is a feasible technique. In our retrospective case series, we found a higher clinical success rate, but no statistical difference was found.
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