DIAGNOSTIC YIELD OF STEREOTAXIC BRAIN BIOPSY GUIDED BY POSITRON EMISSION TOMOGRAPHY WITH [F-18] FLUORODEOXYGLUCOSE
DIAGNOSTIC YIELD OF STEREOTAXIC BRAIN BIOPSY GUIDED BY POSITRON EMISSION TOMOGRAPHY WITH [F-18] FLUORODEOXYGLUCOSE
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DOI：
10.3171/jns.1995.82.3.0445
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发表时间：
1995-03-01
影响因子：
4.1
通讯作者：
BROTCHI, J
中科院分区：
文献类型：
--
作者：
LEVIVIER, M;GOLDMAN, S;BROTCHI, J
本研究的目的是确定是否常规整合正电子发射断层扫描（PET）与F-18标记的氟脱氧葡萄糖（FDG）在规划立体定向脑活检增加技术的诊断率。43例患者根据先前描述的技术进行了FDG-PET和计算机断层扫描（CT）引导的颅内病变立体定向活检。在36例患者中，使用异常FDG摄取区域引导至少一个立体定向活检轨迹。共执行了90个立体定向轨迹;其中，55个基于FDG-PET定义的靶点，35个基于CT定义的靶点。所有患者均获得组织学诊断，但90个轨迹中有6个是非诊断性的;所有6个轨迹均基于仅由CT定义的靶点。基于FDG-PET定义靶点的轨迹诊断率与基于CT定义靶点的轨迹诊断率之间的差异在造影剂增强病变患者中具有统计学意义，但在非增强病变患者中无统计学意义。这些结果支持FDG-PET可能有助于成功管理需要立体定向活检的脑肿瘤患者的观点。由于没有发现与该技术相关的不适或发病率显著增加，因此建议执行立体定向手术并能够使用PET技术的中心应考虑在立体定向活检计划中整合PET数据的类似技术的开发。
The aim of the present study was to determine whether routine integration of positron emission tomography (PET) with F-18-labeled fluorodeoxyglucose (FDG) in the planning of stereotactic brain biopsy increases the technique's diagnostic yield. Forty-three patients underwent combined FDG-PET- and computerized tomography (CT)-guided stereotactic biopsy of intracranial lesions according to a previously described technique. In 36 patients, an area of abnormal FDG uptake was used to guide at least one stereotactic biopsy trajectory. A total of 90 stereotactic trajectories were performed; among them, 55 were based on FDG-PET-defined targets and 35 were based on CT-defined targets. Histological diagnosis was obtained in all patients, but six of the 90 trajectories were nondiagnostic; all six were based on targets defined by CT only. Differences between the diagnostic yield of trajectories based on FDG-PET-defined targets and those based on CT-defined targets were statistically significant in patients with contrast-enhanced lesions, but not in patients with nonenhancing lesions. These results support the view the FDG-PET may contribute to the successful management of brain tumor patients requiring stereotactic biopsy. Because no significant increase in discomfort or morbidity related to the technique was found, it is suggested that the development of similar techniques integrating PET data in the planning of stereotactic biopsy should be considered by centers performing stereotactic surgery and having access to PET technology.