PET/CT guided biopsy of suspected lung lesions requires less rebiopsy than CT guided biopsy due to inconclusive results.

The purpose of this study is to compare FDG PET/CT and CT performance in guiding percutaneous biopsies with histological confirmation of lung lesions. Methods: We prospectively evaluated 341 patients of whom 216 underwent FDG PET/CT-guided biopsy and 125 underwent CT-guided biopsy. The pathology results, lesion size, complications and rebiopsy rate in the two groups were evaluated. Results: Of the 216 biopsies with PET/CT guidance, histology demonstrated 170 lesions (78.7%) to be malignant, and 46 (21.3%) to be benign; In the CT guided group, out of 125 lesions, 77 (61.6%) were malignant and 48 (38.4%) were benign (p = 0.001). Inconclusive results prompted the need for a second biopsy in 18 patients, 13/125 (10.4%) in the CT group and 5 /216 (2.3%) in PET group (p 0.001). Complications rates were: pneumothorax (13.2%), hemothorax (0.8%) and hemoptysis (0.6%). No life-threatening adverse events or fatalities were reported. The difference between complication rates among the 2 groups was not significant (P = 0.6). Malignant lesions showed greater mean size than benign lesions regardless of the group (P = 0.015). Conclusion: PET/CT guided biopsy of lung lesions led to fewer inconclusive biopsies in comparison with CT guided biopsy, with similar complication rates.