Real-time intraprocedural 18F-FDG PET/CT-guided biopsy using automated robopsy arm (ARA) in the diagnostic evaluation of thoracic lesions with prior inconclusive biopsy results: initial experience from a tertiary health care centre

• Published in: British journal of radiology 2017-12, Vol.90 (1080), p.20170258-20170258
• Main Authors: Radhakrishnan, Renjith Kalathoorakathu, Mittal, Bhagwant Rai, Gorla, Arun Kumar Reddy, Basher, Rajender Kumar, Sood, Ashwani, Bal, Amanjit, Kalra, Naveen, Khandelwal, Niranjan, Singh, Navneet, Behera, Digambar
• Format: Article
• Language: English
• Subjects: Diagnostic Radiology; Interventional radiology; PET
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20170258

OBJECTIVEThe aim of this study was to assess the feasibility and appraise the diagnostic utility of real time 18F-FDG PET/CT-guided biopsy under automated robopsy arm (ARA) guidance for the evaluation of thoracic lesions with prior inconclusive biopsy results.METHODSPET/CT-guided biopsy of thoracic lesions was performed in patients who had at least one previous inconclusive biopsy. A total of 25 patients (male:female-18 males, 7 females; age: range, 13-75; mean, 53.7) were included in this study. All these patients underwent percutaneous needle biopsies under real-time PET/CT guidance using ARA (ROBIO-EX, Perfint healthcare Pvt Ltd, Chennai, India) needle navigation technique. Histopathology and clinical follow-up results were reviewed for assessing the accuracy of procedures.RESULTSAdequate representative tissue sample could be retrieved in all the patients. No major procedure-related complications were encountered in any patient. Of the 25 procedures, 21 lesions were positive for malignancy and benign findings were observed in the other 4 lesions on histopathology. None of the patients required further biopsy in arriving at a final diagnosis. Overall diagnostic yield of the procedure was 100%.CONCLUSIONReal time 18F-FDG PET/CT guidance for percutaneous biopsies of lung and mediastinal lesions is a feasible technique with potential utility in patients with previous inconclusive biopsy results. Advances in knowledge: 18F-FDG PET/CT guidance reduces the sampling errors by specifically targeting areas of viability and avoiding necrosis/atelectasis. A navigational tool like ARA is thought to help in accurately targeting these areas.