Clinical and FDG-PET/CT Suspicion of Malignant Disease: Is Biopsy Confirmation Still Necessary?

18F-FDG PET-CT biopsy cancer malignancy tumors

Journal

Diagnostics (Basel, Switzerland)
ISSN: 2075-4418
Titre abrégé: Diagnostics (Basel)
Pays: Switzerland
ID NLM: 101658402

Informations de publication

Date de publication:
20 Mar 2021
Historique:
received: 19 02 2021
revised: 13 03 2021
accepted: 17 03 2021
entrez: 3 4 2021
pubmed: 4 4 2021
medline: 4 4 2021
Statut: epublish

Résumé

Biopsy of This single-center retrospective study included 83 patients who had undergone FDG-PET/CT within 60 days before CT- or ultrasonography-guided tissue sampling and whose request form for CT- or US-guided tissue sampling requested mutation analyses. The latter implies a high clinical suspicion of active malignant disease. The nature of each biopsied lesion was determined based on the results of the pathological analysis and/or clinical and imaging follow-up of at least 12 months. In total, eighty-eight FDG-avid lesions were biopsied. The PPV of FDG-PET/CT for malignancy was 98.9% (95% CI: 93.8-99.8%). For patients with an oncological history, the PPV was 98.7% (95% CI: 92.9-99.8%), and for patients with no oncological history, the PPV was 100% (95% CI: 74.1-100.0%). There was no significant difference between the PPV of the group with and without an oncological history ( Although the PPV of FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease is high, biopsy remains recommended to avoid inappropriate patient management due the non-negligible chance of dealing with FDG-avid benign disease or unexpected malignancies.

Sections du résumé

BACKGROUND BACKGROUND
Biopsy of
METHODS METHODS
This single-center retrospective study included 83 patients who had undergone FDG-PET/CT within 60 days before CT- or ultrasonography-guided tissue sampling and whose request form for CT- or US-guided tissue sampling requested mutation analyses. The latter implies a high clinical suspicion of active malignant disease. The nature of each biopsied lesion was determined based on the results of the pathological analysis and/or clinical and imaging follow-up of at least 12 months.
RESULTS RESULTS
In total, eighty-eight FDG-avid lesions were biopsied. The PPV of FDG-PET/CT for malignancy was 98.9% (95% CI: 93.8-99.8%). For patients with an oncological history, the PPV was 98.7% (95% CI: 92.9-99.8%), and for patients with no oncological history, the PPV was 100% (95% CI: 74.1-100.0%). There was no significant difference between the PPV of the group with and without an oncological history (
CONCLUSION CONCLUSIONS
Although the PPV of FDG-PET/CT for malignancy in patients with a clinical suspicion of active malignant disease is high, biopsy remains recommended to avoid inappropriate patient management due the non-negligible chance of dealing with FDG-avid benign disease or unexpected malignancies.

Identifiants

pubmed: 33804753
pii: diagnostics11030559
doi: 10.3390/diagnostics11030559
pmc: PMC8003997
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Radiographics. 2016 Mar-Apr;36(2):481-96
pubmed: 26963458
Semin Nucl Med. 2007 Nov;37(6):400-19
pubmed: 17920348
Ann Nucl Med. 2001 Dec;15(6):471-86
pubmed: 11831394
Semin Nucl Med. 2007 May;37(3):206-22
pubmed: 17418153
J Cancer Res Ther. 2017 Oct-Dec;13(6):1000-1006
pubmed: 29237966
Mol Imaging Radionucl Ther. 2018 Oct 09;27(3):126-132
pubmed: 30317849
Acad Radiol. 2014 Feb;21(2):232-49
pubmed: 24439337
Psychooncology. 2012 Jan;21(1):1-10
pubmed: 22905349
Cancer Imaging. 2012 Oct 16;12:437-46
pubmed: 23092816
Eur J Nucl Med Mol Imaging. 2015 Feb;42(2):328-54
pubmed: 25452219
AJR Am J Roentgenol. 2013 Aug;201(2):433-8
pubmed: 23883226
Eur Radiol. 2019 Jul;29(7):3372-3378
pubmed: 30666444
Cancers (Basel). 2014 Sep 29;6(4):1821-89
pubmed: 25268160
Pers Soc Psychol Bull. 2015 Nov;41(11):1551-9
pubmed: 26338852
AJR Am J Roentgenol. 2007 Nov;189(5):1203-10
pubmed: 17954662

Auteurs

Talitha Bent (T)

Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 Groningen, The Netherlands.

Derya Yakar (D)

Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 Groningen, The Netherlands.

Thomas C Kwee (TC)

Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 Groningen, The Netherlands.

Classifications MeSH