Post-therapy lesions in patients with non-Hodgkin's lymphoma characterized by 18F-FDG PET/CT-guided biopsy using automated robotic biopsy arm

PurposeThe aim of this study was to analyse the positive predictive value (PPV) of post-therapy fluorine-18-fluorodeoxyglucose (F-18-FDG) PET/CT performed for response or recurrence evaluation in patients with non-Hodgkin's lymphoma (NHL) and to appraise the diagnostic utility of F-18-FDG PET/CT-guided biopsy in this setting.Patients and methodsA total of 17 patients with NHL showing F-18-FDG avid lesions in F-18-FDG PET/CT performed for response or recurrence assessment underwent F-18-FDG PET/CT-guided biopsy using automated robotic biopsy arm needle navigation technique. The objectives were analysed in reference to histopathology.ResultsIn all, 15 of the 17 (88.5%) procedures yielded adequate representative tissue samples. Nine out of 15 lesions were positive for residual disease and the remaining revealed benign findings on histopathology. One patient with inconclusive biopsy underwent surgical resection and histopathology confirmed the presence of residual disease. PPV of the(18)F-FDG PET/CT was observed to be 62.5% (10/16).Conclusion(18)F-FDG PET/CT for response evaluation in NHL possesses a low PPV and hence warrants histopathological correlation when F-18-FDG PET/CT findings influence management decision. Diagnostic yield of F-18-FDG PET/CT-guided biopsy is high and has the potential to reduce sampling errors.