DIAGNOSTIC YIELD OF STEREOTAXIC BRAIN BIOPSY GUIDED BY POSITRON EMISSION TOMOGRAPHY WITH [F-18] FLUORODEOXYGLUCOSE

The aim of the present study was to determine whether routine integrat ion of positron emission tomography (PET) with F-18-labeled fluorodeox yglucose (FDG) in the planning of stereotactic brain biopsy increases the technique's diagnostic yield. Forty-three patients underwent combi ned FDG-PET- and computerized tomography (CT)-guided stereotactic biop sy of intracranial lesions according to a previously described techniq ue. In 36 patients, an area of abnormal FDG uptake was used to guide a t least one stereotactic biopsy trajectory. A total of 90 stereotactic trajectories were performed; among them, 55 were based on FDG-PET-def ined targets and 35 were based on CT-defined targets. Histological dia gnosis was obtained in all patients, but six of the 90 trajectories we re nondiagnostic; all six were based on targets defined by CT only. Di fferences between the diagnostic yield of trajectories based on FDG-PE T-defined targets and those based on CT-defined targets were statistic ally significant in patients with contrast-enhanced lesions, but not i n patients with nonenhancing lesions. These results support the view t he FDG-PET may contribute to the successful management of brain tumor patients requiring stereotactic biopsy. Because no significant increas e in discomfort or morbidity related to the technique was found, it is suggested that the development of similar techniques integrating PET data in the planning of stereotactic biopsy should be considered by ce nters performing stereotactic surgery and having access to PET technol ogy.