Feasibility of In Situ, High-Resolution Correlation of Tracer Uptake with Histopathology by Quantitative Autoradiography of Biopsy Specimens Obtained Under 18F-FDG PET/CT Guidance

Journal of Nuclear Medicine

Aditya P. Apte¹  Heiko Schöder¹  Andre L. Moreira¹  Jeremy C. Durack¹  Joseph P. Erinjeri¹  Stephen B. Solomon¹  Joseph O. Deasy¹  C. Ross Schmidtlein¹  Snjezana Dogan¹  Constantinos T. Sofocleous¹  Robert H. Siegelbaum¹  Majid Maybody¹  Assen S. Kirov¹  John L. Humm¹  Sean A. Carlin¹  Louise M. Fanchon¹  Ellen Yorke¹  Irene A. Burger¹ 

关键词: autoradiography;    biopsy;    PET/CT;    histopathology;    oncology;   

DOI  :  10.2967/jnumed.114.148668

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Core biopsies obtained using PET/CT guidance contain bound radiotracer and therefore provide information about tracer uptake in situ. Our goal was to develop a method for quantitative autoradiography of biopsy specimens (QABS), to use this method to correlate 18F-FDG tracer uptake in situ with histopathology findings, and to briefly discuss its potential application. Methods: Twenty-seven patients referred for a PET/CT-guided biopsy of 18F-FDG–avid primary or metastatic lesions in different locations consented to participate in this institutional review board–approved study, which complied with the Health Insurance Portability and Accountability Act. Autoradiography of biopsy specimens obtained using 5 types of needles was performed immediately after extraction. The response of autoradiography imaging plates was calibrated using dummy specimens with known activity obtained using 2 core-biopsy needle sizes. The calibration curves were used to quantify the activity along biopsy specimens obtained with these 2 needles and to calculate the standardized uptake value, SUVARG. Autoradiography images were correlated with histopathologic findings and fused with PET/CT images demonstrating the position of the biopsy needle within the lesion. Logistic regression analysis was performed to search for an SUVARG threshold distinguishing benign from malignant tissue in liver biopsy specimens. Pearson correlation between SUVARG of the whole biopsy specimen and average SUVPET over the voxels intersected by the needle in the fused PET/CT image was calculated. Results: Activity concentrations were obtained using autoradiography for 20 specimens extracted with 18- and 20-gauge needles. The probability of finding malignancy in a specimen is greater than 50% (95% confidence) if SUVARG is greater than 7.3. For core specimens with preserved shape and orientation and in the absence of motion, one can achieve autoradiography, CT, and PET image registration with spatial accuracy better than 2 mm. The correlation coefficient between the mean specimen SUVARG and SUVPET was 0.66. Conclusion: Performing QABS on core-biopsy specimens obtained using PET/CT guidance enables in situ correlation of 18F-FDG tracer uptake and histopathology on a millimeter scale. QABS promises to provide useful information for guiding interventional radiology procedures and localized therapies and for in situ high-spatial-resolution validation of radiopharmaceutical uptake.

【 授权许可】

Unknown