The unique ability of FDG-PET/CT imaging to investigate the biologic behavior of tumors by providing metabolic information has revolutionized the management of oncological diseases. In addition to its contribution to the diagnosis, staging, restaging, and monitoring of cancer therapy, FDG-PET/CT has been shown by our group as a useful technique to guide various interventional procedures (1). FDG-PET/CT has been used to plan biopsies (2, 3), surgery (4), and radiotherapy (5–9), and was recently added to the armamentarium of interventional radiologists as a guiding tool for biopsies and percutaneous ablations (1, 10).

Despite recent advances in medicine, particularly in imaging, definite diagnoses of a vast majority of cancers still rely on histopathological diagnosis. Percutaneous image-guided biopsies have become an invaluable tool in the care of patients with cancer. Biopsy with fine needles, or large needles in some cases, can be obtained with a percutaneous approach under cross-sectional imaging guidance. However, commonly used cross-sectional imaging modalities such as ultrasound (US), CT, and MRI provide largely anatomical and morphological information that sometimes may not be adequate enough to select the appropriate mass or a part of a mass to biopsy. Besides helping to select the metabolically active viable tumor tissue in order to improve pathological yield and to minimize sampling errors, the metabolic information provided by FDG-PET/CT allows for the visualization of a metabolically active mass without morphologic correlate on other cross-sectional imaging modalities while targeting the tumor during biopsy.