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Feasibility for in situ, High Resolution Correlation of Tracer Uptake with Histopathology by Quantitative Autoradiography of Biopsy Specimens Obtained under FDG PET/CT Guidance


Fanchon, Louise M; Dogan, Snjezana; Moreira, Andre L; Carlin, Sean A; Schmidtlein, C Ross; Yorke, Ellen; Apte, Aditya; Burger, Irene A; Durack, Jeremy C; Erinjeri, Joseph P; Maybody, Majid; Schöder, Heiko; Siegelbaum, Robert H; Sofocleous, Constantinos T; Deasy, Joseph O; Solomon, Stephen B; Humm, John L; Kirov, Assen S (2015). Feasibility for in situ, High Resolution Correlation of Tracer Uptake with Histopathology by Quantitative Autoradiography of Biopsy Specimens Obtained under FDG PET/CT Guidance. Journal of Nuclear Medicine, 56(4):538-544.

Abstract

Core biopsies obtained using PET/CT guidance contain bound radiotracer and therefore provide information about tracer uptake in situ. Our goal is to develop a method for Quantitative Autoradiography of Biopsy Specimens (QABS), to use this method to correlate (18)F-fluorodeoxyglucose (FDG) tracer uptake in situ with histopathology findings, and to briefly discuss its potential application. METHODS Twenty seven (27) patients referred for a PET/CT-guided biopsy of FDG-avid primary or metastatic lesions in different locations consented to participate in this institutional review board-approved, HIPAA compliant study. Autoradiography (ARG) of biopsy specimens obtained using five types of needles was performed immediately after extraction. The response of ARG imaging plates was calibrated using dummy specimens with known activity obtained using two core biopsy needle sizes. The calibration curves were used to quantify the activity along biopsy specimens obtained with these two needles and to calculate standardized uptake values, SUVARG. ARG 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 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 was calculated. RESULTS Activity concentrations were obtained using ARG for 20 specimens extracted with 18G and 20G needles. The probability for finding malignancy in a specimen is larger than 50% (95 % confidence) if SUVARG is larger than 7.3. For core specimens with preserved shape and orientation and in the absence of motion, ARG, CT and PET images registration with spatial accuracy better than 2 mm is achievable. The correlation coefficient between specimen mean SUVARG and SUVPET was 0.66. CONCLUSION Performing QABS on core biopsy specimens obtained using PET/CT guidance enables in situ correlation of 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 radiopharmaceuticals uptake.

Abstract

Core biopsies obtained using PET/CT guidance contain bound radiotracer and therefore provide information about tracer uptake in situ. Our goal is to develop a method for Quantitative Autoradiography of Biopsy Specimens (QABS), to use this method to correlate (18)F-fluorodeoxyglucose (FDG) tracer uptake in situ with histopathology findings, and to briefly discuss its potential application. METHODS Twenty seven (27) patients referred for a PET/CT-guided biopsy of FDG-avid primary or metastatic lesions in different locations consented to participate in this institutional review board-approved, HIPAA compliant study. Autoradiography (ARG) of biopsy specimens obtained using five types of needles was performed immediately after extraction. The response of ARG imaging plates was calibrated using dummy specimens with known activity obtained using two core biopsy needle sizes. The calibration curves were used to quantify the activity along biopsy specimens obtained with these two needles and to calculate standardized uptake values, SUVARG. ARG 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 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 was calculated. RESULTS Activity concentrations were obtained using ARG for 20 specimens extracted with 18G and 20G needles. The probability for finding malignancy in a specimen is larger than 50% (95 % confidence) if SUVARG is larger than 7.3. For core specimens with preserved shape and orientation and in the absence of motion, ARG, CT and PET images registration with spatial accuracy better than 2 mm is achievable. The correlation coefficient between specimen mean SUVARG and SUVPET was 0.66. CONCLUSION Performing QABS on core biopsy specimens obtained using PET/CT guidance enables in situ correlation of 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 radiopharmaceuticals uptake.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:26 February 2015
Deposited On:02 Apr 2015 07:34
Last Modified:05 Apr 2016 19:11
Publisher:Society of Nuclear Medicine
ISSN:0161-5505
Publisher DOI:https://doi.org/10.2967/jnumed.114.148668
PubMed ID:25722446

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