PET/CT-Guided Biopsy of Suspected Lung Lesions Requires Less Rebiopsy Than CT-Guided Biopsy Due to Inconclusive Results.

Abstract

The purpose of this study was to compare ¹⁸F-FDG PET/CT and CT performance in guiding percutaneous biopsies with histologic confirmation of lung lesions. <b>Methods:</b> We prospectively evaluated 341 patients, of whom 216 underwent ¹⁸F-FDG PET/CT-guided biopsy and 125 underwent CT-guided biopsy. The pathology results, lesion size, complications, and rebiopsy rate in the 2 groups were evaluated. <b>Results:</b> Of the 216 biopsies with PET/CT guidance, histology demonstrated 170 lesions (78.7%) to be malignant and 46 (21.3%) to be benign. In the CT-guided group, of 125 lesions, 77 (61.6%) were malignant and 48 (38.4%) were benign (<i>P</i> = 0.001). Inconclusive results prompted the need for a second biopsy in 18 patients: 13 of 125 (10.4%) in the CT group and 5 of 216 (2.3%) in PET group (<i>P</i> = 0.001). Complications were pneumothorax (13.2%), hemothorax (0.8%), and hemoptysis (0.6%). No life-threatening adverse events or fatalities were reported. The difference in complication rates between the 2 groups was not significant (<i>P</i> = 0.6). Malignant lesions showed a greater mean size than benign lesions regardless of the group (<i>P =</i> 0.015). <b>Conclusion:</b> PET/CT-guided biopsy of lung lesions led to fewer inconclusive biopsies than CT-guided biopsy, with similar complication rates.