Functional and metabolic imaging in transthoracic biopsies guided by computed tomography.
Eur Radiol
; 30(4): 2041-2048, 2020 Apr.
Article
em En
| MEDLINE
| ID: mdl-31900696
ABSTRACT
OBJECTIVES:
CT-guided biopsy of indeterminate lung lesions sometimes provides insufficient histological results due to tumor necrosis. Functional and metabolic methods such as DWI-MR and PET-CT may help by directing sample collection to a lesion area of greater biological representativeness. The objective is to evaluate the histopathological results based on findings on ADC and SUV levels in lung lesions suspected for primary cancer.METHODS:
Tissue samples were evaluated after undergoing biopsies guided by either DWI-MR or PET-CT findings. In each patient, sample collection from two lesion areas was guided by local ADC and SUV. Values were used to define areas of low vs. high suspicion for cancer.RESULTS:
Patients who underwent DWI-MR had median lesion size of 78.0 mm. Areas of higher suspicion (HSA) had a median ADC of 1.1 × 10-3 mm2/s, while areas of lower suspicion (LSA) had median ADC of 1.8 × 10-3 mm2/s (p = 0.0001). All HSA samples and 71.43% of LSA samples were positive for cancer (p = 0.0184). Patients who performed PET-CT had median lesion size of 61.0 mm. Median SUV was 7.1 for HSA and 3.9 for LSA (p = 0.0002). Positivity for cancer was observed in 76.9% of samples for both HSA and LSA (p = 0.0522).CONCLUSION:
Use of DWI-MR and PET-CT showed that tumors are functional and metabolically heterogeneous and that this heterogeneity has implications for histopathological diagnosis. KEY POINTS ⢠Lung cancer is heterogeneous regarding functional and metabolic imaging. ⢠Tumor heterogeneity may have implications in histopathological diagnosis. ⢠Intralesional lower levels of ADC target highly suspected areas with a significant improvement in lung cancer diagnosis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imagem de Difusão por Ressonância Magnética
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Biópsia Guiada por Imagem
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Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
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Pulmão
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Neoplasias Pulmonares
Tipo de estudo:
Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Brasil