Keywords:
CT, Nuclear medicine, Mediastinum, Hybrid Imaging, Biopsy, Lymphoma
Authors:
D. Stefanou, S. Georgakopoulos, A. Hopkins, D. CHONDROS , D. Exarhos; ATHENS/GR
DOI:
10.26044/ecr2019/C-1902
Conclusion
Our restrospective study provides support for the use of FDG- PET/CT to improve the diagnostic accuracy of percutaneous CT-guided mediastinal biopsy,
guiding the operator to the most metabolically active area of the lesion.
It consequently,
reduces the potential need for repeated invasive procedures- multiple needle passes for obtaining tissue sample and the risk of complications.
Whilst,
PET/CT does not offer extra information from CT or MRI scans conserning tumor necrosis.
In one case we changed initial biopsy plans due to PET/CT,
because we felt it was safer to biopsy the adrenal gland (Figure 4).
Even though the number of patients is small in our retrospective study,
we conclude that a successful mediastinal biopsy depends on the use of large core biopsy needle,
18-16g.
The number of needle passes also increases the success rate.
Mediastinal biopsy should always be performed initially when a tumor is detected leaving the unsuccessful cases to surgical intervention.
In our series the two unsucceful biopsies concerned non Hodgkin lymphoma.
Limitations of our retrospective analysis is the unavailability of co-axial needles.