Diagnostic value of 18 F-FDG PET-CT combined with ultrasound-guided percutaneous core needle biopsy for patients with primary gastrointestinal lymphomas: a multicenter study

To assess the efficacy and safety of 18 F-FDG PET-CT combined with ultrasound-guided percutaneous core needle biopsy in diagnosing primary gastrointestinal lymphomas (PGILs). Patients with suspected PGILs who were admitted to Fujian Provincial Hospital and Fujian Medical University Union Hospital between January 2014 and April 2022 were selected; gastrointestinal hypermetabolic lesions were identified with 18 F-FDG PET-CT, and ultrasound-guided percutaneous core needle biopsies were performed accordingly. Patients confirmed with PGILs by endoscopic biopsy or after-resection biopsy during the same period were included in the control groups. Intergroup comparisons were made in the aspects of complications after biopsy, histopathological sampling satisfaction, days between biopsy and the initiation of chemotherapy, and expenses. Of 98 patients included in the study, 20 were in the ultrasound-guided percutaneous core needle biopsy group, 44 in the endoscopic biopsy group and 34 in the after-resection biopsy group. All patients were histopathologically diagnosed with non-Hodgkin’s lymphomas. The sampling success rates were 90% for the ultrasound-guided percutaneous core needle biopsy group, 100% for the after-resection biopsy group, and 75% for the endoscopic biopsy group. No patient in the ultrasound-guided percutaneous core needle biopsy group developed complications (e.g., local hemorrhage, perforation and infection). One patient (2.2%) in the endoscopic biopsy group experienced hemorrhage. The complication incidence rates of the after-resection biopsy group (fever, 32.3%; infection, 20.5%) were much higher. For the ultrasound-guided percutaneous core needle biopsy group, the procedure durations were 14.45 ± 1.93 min, the days between biopsy and the initiation of chemotherapy were 9.80 ± 4.26 days, and the biopsy-associated costs RMB5,505 ± 1,743; all conspicuously lower than those for the endoscopic biopsy group and the after-resection biopsy group (P < 0.001). 18 F-FDG PET-CT combined with ultrasound-guided percutaneous core needle biopsy is safer, more effective and faster in diagnosing PGILs than endoscopic biopsy or surgical biopsy.