Our Summary

This research paper compares two methods of guiding biopsies for lung lesions: using 18F-FDG PET/CT scans and using traditional CT scans. The study involved 341 patients, with 216 having their biopsies guided by PET/CT scans and 125 by CT scans.

The results showed that the PET/CT-guided biopsies were more accurate in determining whether lesions were malignant (cancerous) or benign (non-cancerous), with fewer inconclusive results that required a second biopsy. Of the biopsies guided by PET/CT, 78.7% were found to be malignant and 21.3% benign, whereas in the CT-guided group, 61.6% were malignant and 38.4% were benign.

The study also found that the rate of complications, such as pneumothorax (air trapped in the space around the lungs), hemothorax (blood in the space around the lungs), and hemoptysis (coughing up blood), were similar for both methods. No severe adverse events or deaths were reported.

The study concludes that using PET/CT to guide biopsies for lung lesions resulted in fewer inconclusive results and similar rates of complications as traditional CT-guided biopsies.

FAQs

  1. What were the two methods compared in the study for guiding lung biopsies?
  2. What were the main findings of the study in terms of accuracy and complication rates between PET/CT-guided and CT-guided lung biopsies?
  3. Were there any severe adverse events or deaths reported in the study of PET/CT and CT-guided lung biopsies?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung biopsy is to discuss the option of using PET/CT scans to guide the biopsy. This method may provide more accurate results in determining whether a lung lesion is cancerous or non-cancerous, and may reduce the need for a second biopsy. Additionally, the risk of complications is similar between PET/CT-guided and traditional CT-guided biopsies. It’s important for patients to have a thorough discussion with their healthcare provider about the best approach for their specific situation.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspicious lung lesions or nodules identified on imaging studies such as chest X-rays, CT scans, or PET scans. These lesions may be found incidentally or may be causing symptoms such as coughing, shortness of breath, chest pain, or coughing up blood. Patients with a history of smoking, exposure to asbestos or other carcinogens, or a family history of lung cancer may also be recommended for a lung biopsy to further evaluate suspicious findings.

In this particular study comparing PET/CT-guided and CT-guided biopsies for lung lesions, patients with lesions that were deemed suspicious for malignancy based on imaging studies were included. The study found that PET/CT-guided biopsies were more accurate in determining the nature of the lesions, with fewer inconclusive results compared to CT-guided biopsies. This suggests that PET/CT-guided biopsies may be particularly beneficial for patients with suspicious lung lesions that require further evaluation.

Overall, patients who are recommended for a lung biopsy are those with concerning findings on imaging studies that need to be further evaluated to determine whether the lesions are cancerous or benign. The choice of biopsy guidance method, whether PET/CT or CT, may depend on factors such as the size and location of the lesion, the patient’s overall health status, and the expertise of the healthcare provider performing the procedure.

Timeline

Here is a brief timeline of what a patient may experience before and after a lung biopsy:

Before the biopsy:

  1. Patient consults with a healthcare provider about the need for a lung biopsy based on imaging results showing a suspicious lesion.
  2. Patient undergoes pre-operative tests, such as blood work and chest X-rays, to assess their overall health and suitability for the procedure.
  3. Patient may need to stop taking certain medications, such as blood thinners, in the days leading up to the biopsy.
  4. Patient is given instructions on fasting before the procedure and what to expect during and after the biopsy.

During the biopsy:

  1. Patient arrives at the hospital or outpatient clinic and is prepared for the procedure, which may involve changing into a hospital gown.
  2. Patient is given local anesthesia to numb the area where the biopsy needle will be inserted.
  3. A needle is guided into the lung lesion using either a PET/CT or CT scan for guidance.
  4. Tissue samples are collected and sent to a lab for analysis to determine if the lesion is cancerous or benign.
  5. The procedure typically takes about 30 minutes to an hour.

After the biopsy:

  1. Patient is monitored for a few hours to ensure there are no immediate complications, such as bleeding or breathing difficulties.
  2. Patient may experience some pain or discomfort at the biopsy site, which can be managed with over-the-counter pain medications.
  3. Patient is given instructions on caring for the biopsy site, such as keeping it clean and dry.
  4. Patient may be advised to avoid strenuous activities for a few days to allow the biopsy site to heal.
  5. Patient follows up with their healthcare provider to discuss the biopsy results and determine the next steps in their treatment plan.

What to Ask Your Doctor

Some questions a patient may want to ask their doctor about lung biopsy include:

  1. What is the purpose of the biopsy and what information will it provide about my lung lesion?
  2. Why is a PET/CT scan being used to guide the biopsy instead of a traditional CT scan?
  3. What are the risks and potential complications associated with the biopsy procedure?
  4. How will the biopsy results impact my treatment plan and prognosis?
  5. How long will it take to receive the biopsy results?
  6. Will I need to take any special precautions or follow any specific instructions before or after the biopsy procedure?
  7. How experienced is the healthcare team in performing PET/CT-guided lung biopsies?
  8. Are there any alternative methods for obtaining a tissue sample from the lung lesion?
  9. What is the likelihood of needing a second biopsy if the results are inconclusive?
  10. What follow-up care and monitoring will be necessary after the biopsy procedure?

Reference

Authors: Cerci JJ, Bogoni M, Cerci RJ, Masukawa M, Neto CCP, Krauzer C, Fanti S, Sakamoto DG, Barreiros RB, Nanni C, Vitola JV. Journal: J Nucl Med. 2021 Aug 1;62(8):1057-1061. doi: 10.2967/jnumed.120.252403. Epub 2020 Dec 31. PMID: 33384323