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Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2006; 12(15): 2388-2393
Published online Apr 21, 2006. doi: 10.3748/wjg.v12.i15.2388
Accuracy of combined PET/CT in image-guided interventions of liver lesions: An ex-vivo study
Patrick Veit, Christiane Kuehle, Thomas Beyer, Hilmar Kuehl, Andreas Bockisch, Gerald Antoch
Patrick Veit, Christiane Kuehle, Thomas Beyer, Hilmar Kuehl, Andreas Bockisch, Gerald Antoch, Department of Diagnostic and Interventional Radiology and Neuroradiology Department of Nuclear Medicine University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
Correspondence to: Patrick Veit, MD, Department of Diagnostic and Interventional Radiology, University Hospital of Essen, Hufelandstrasse 55, 45122 Essen, Germany. patrick.veit@uni-essen.de
Telephone: +49-201-7231528 Fax: +49-201-7231563
Received: August 26, 2005
Revised: October 12, 2005
Accepted: October 26, 2005
Published online: April 21, 2006

AIM: Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies.

METHODS: Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of 18F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square (RMS) was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference.

RESULTS: In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions.

CONCLUSION: Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions. Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device, but may also be beneficial for guidance in interventional liver procedures.

Keywords: Liver biopsy, Radiofrequency ablation, Combined PET/CT, ex-vivo study, Image guided interventions