A novel stereotactic frame for real PET-guided biopsies: A preclinical proof-of-concept

Purpose: To design, build and test a stereotactic device that allows PET image-guided biopsies to be performed. Methods: An initial prototype consisting of four main pieces, one of which contains radioactive markers to make it visible in the PET images, was built using a 3D printer. Once the device is mounted, a spherical coordinate system is built with the entrance needle point in the skin as the origin of coordinates. Two in-house software programs, namely getCoord.ijm, which obtains the spherical coordinates of the tumour tissue to be biopsied, and getNeedle.ijm, which virtualizes the inner needle tip once the puncture has taken place, were written. This prototype was tested on an FDG-doped phantom to characterize both the accuracy of the system and the procedure time. Results: Up to 11 complete biopsy procedures were conducted. The mean total procedure time was less than 20 min, which is less than the procedure time of conventional standard CT-guided biopsies. The overall accuracy of the system was found to be 5.0 ± 1.3 mm, which outperforms the criterion used in routine clinical practice when targeting tumours with a diameter of 10 mm. Conclusions: A stereotactic frame to conduct real PET image-guided biopsies has been designed and built. A proof-of-concept was performed to characterize the system. The procedure time and accuracy of the system were found to meet the current needs of physicians performing biopsies.