Robot-Assisted PET/CT-Guided Biopsy in Pelvic Malignancies: A Promising Approach for Accurate Diagnosis and Precision Medicine

Precise diagnosis of deep pelvic malignancies in patients is challenging due to complex anatomy and limited access. This case series explores the feasibility and accuracy of trans gluteal robot-assisted PET/CT-guided biopsy to overcome such limitations. All three patients underwent a focused regional PET/CT scan of the pelvis using the GE Discovery 690 PET/CT system, 40 minutes post-injection of 2–3 mCi of ¹⁸ F FDG. Due to deep pelvic lesion locations, a trans gluteal robotic-assisted approach was selected. Pre-procedural assessment included hemogram and PT INR testing. Patients were prepared with a high-fibre diet and a phosphate enema for bowel clearance. Robotic planning software was used for needle trajectory mapping based on SUVmax, optimising target localisation while avoiding critical structures. Biopsies were performed under PET/CT guidance. All three procedures were technically successful and led to histopathological confirmation of malignancy. The approach demonstrated superior lesion accessibility and patient safety with minimal complications. Transgluteal robot-assisted PET/CT-guided biopsy provides a minimally invasive, precise diagnostic technique for pelvic malignancies, potentially improving diagnostic yield and guiding personalised treatment.