The Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio is a referral center in Italy for liver procedures, particularly ablation and biopsies that are generally performed under ultrasound guidance, said presenter Dr. Giovanni Mauri. However, sometimes PET-positive tumors cannot be visualized very well on ultrasound. In these cases, accurate targeting for biopsy or ablation may be extremely useful, he said.
"Moreover, some tumors are not homogeneously FDG-avid, and targeting the most avid part for a biopsy may decrease the false-negative result," he said. "In previously ablated cases that developed a marginal recurrence, it is often difficult with ultrasound to clearly identify the viable portion of the tumor for a second ablation."
While PET/CT-guided biopsy or ablation has been suggested for these cases, this would require a complex and dedicated environment, a long time, and additional radiation exposure to the patient, Mauri said. As a result, the group decided to investigate the feasibility of combining ultrasound, PET, and contrast-enhanced CT.
"With this study, we demonstrate that percutaneous-guided biopsy and ablations with the use of real-time image fusion between contrast-enhanced CT, F-18 FDG PET, and ultrasound is feasible," Mauri told AuntMinnie.com. "This method can be used during percutaneous biopsy and ablation to increase the targeting accuracy of FDG-avid tumors and holds potential for offering ablation and biopsy to additional patient populations."