Comparison of CT-guided percutaneous biopsy with and without registration of prior PET/CT images to diagnose mediastinal tumors

Cardiovasc Intervent Radiol. 2014 Oct;37(5):1306-11. doi: 10.1007/s00270-013-0793-x. Epub 2013 Nov 22.

Abstract

Purpose: To compare computed tomography (CT)-guided percutaneous biopsy with and without registration of prior positron emission tomography (PET)/CT images in the diagnosis of mediastinal tumors.

Methods: We performed clinically indicated percutaneous biopsy in 106 patients with mediastinal tumors in the anterior (n = 61), posterior (n = 21), middle (n = 16), and superior mediastinum (n = 8). The final diagnosis was based on surgical outcomes, or imaging findings and the results of at least 6-month follow-up. The patients underwent CT-guided percutaneous biopsy with (group 1, n = 56) or without (group 2, n = 50) registration of prior PET/CT images obtained no more than 22 days earlier. The registered images were used to plan the procedure and help target the tumors.

Results: CT-guided percutaneous needle biopsy yielded adequate samples in 101 of 106 (95 %) patients (group 1, n = 53; group 2, n = 48); in 95 patients (94 %), the diagnosis was confirmed by specific histological typing (group 1, n = 51; group 2, n = 44). The diagnostic accuracy of CT-guided percutaneous biopsy with and without the registration of prior PET/CT images was not statistically different (group 1, 96 %; group 2, 93 %, p = 0.324).

Conclusion: CT-guided percutaneous biopsy is an easy and safe procedure that can provide a precise diagnosis in the majority of mediastinal tumors. PET/CT-guided biopsy yielded no special diagnostic advantages.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Aged
  • Biopsy, Needle
  • Female
  • Follow-Up Studies
  • Humans
  • Image-Guided Biopsy / methods
  • Male
  • Mediastinal Neoplasms / diagnosis*
  • Mediastinum / diagnostic imaging
  • Middle Aged
  • Multimodal Imaging / methods*
  • Positron-Emission Tomography / methods*
  • Radiography, Interventional / methods*
  • Reproducibility of Results
  • Tomography, X-Ray Computed / methods*
  • Young Adult