A case series on the role of (18)F-FDG PET/CT-guided biopsy of osseous metastases

PURPOSE: This case series explores the utility of positron emission tomography (PET)/computed tomography (CT) guidance for biopsy of (18)F-fludeoxyglucose (FDG)-avid osseous lesions that are inconspicuous on CT. METHODS: PET/CT-guided core biopsies were performed in four patients with suspected malignancies given (18)F-FDG-avid osseous lesions that were inconspicuous on CT alone. The final diagnosis for each patient was determined by histopathological and molecular testing. RESULTS: PET/CT-guided biopsy yielded accurate sampling via core needle biopsy (CNB) with histopathological confirmation of osseous metastases of the primary malignancy as opposed to a secondary malignancy in three patients and ruled-out metastatic spread in the fourth. CONCLUSION: PET/CT-guided biopsy of hypermetabolic osseous lesions that are inconspicuous on CT alone is an effective and safe diagnostic tool in patients with suspected malignancy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41824-021-00095-1.