Objective: To evaluate the clinical significance of percutaneous puncture biopsy guided
by fused and 3D-reconstructed positron-emission tomography (PET) / computed tomography (CT)
images in diagnosing deep lesions.
Methods: According to the CT morphological information obtained from 47 patients who need to
undertake percutaneous needle biopsy after PET/CT examination, two associate chief physicians
selected the lesion with SUVmax >2.5 as the target spot of the surgery. The two operators performed
a first CT scan of the lesion to define an optimal puncture path. After CT scan, images with
a thickness of 1.5 mm were transmitted to the processing center, then fused and 3D-reconstructed
with PET images. When the target lesion area was clearly identified and selected, an 18G biopsy
needle was threaded through the trocar to incise the tissues inside the lesion. Pathological examination
of the target lesion tissue was accomplished.
Results: Using images obtained from the same instrument, location, shape and 2-[18F]-fluoro-2-
deoxy-D-glucose (FDG) uptake of deep lesions were clearly and dimensionally displayed, thus the
biopsy needle was precisely guided through its pathway to the hypermetabolic lesion. All percutaneous
puncture biopsies were successfully accomplished (100%), with an accuracy of 97.9%
(46/47) and an average surgical duration of 17.3±9.5 min. All post-operative pathological examinations
achieved a precise diagnosis.
Conclusions: With the guidance of fused and 3D-reconstructed PET/CT images, the lesion could
be precisely identified. Hence, percutaneous needle biopsy obtained from morphology-guided to
metabolism-guided techniques has a clear significance in clinical practice.