When performing image-guided biopsy of an anatomical structure in a patient, a target anatomical patient region containing biopsy target is imaged using both SPECT and XCT concurrently. 3D SPECT and XCT image data is fused to generate a fused 3D reference image that is overlaid on 2D patient image(s) generated during the biopsy procedure to generate an overlay image. The overlay image also includes a planned path or trajectory for a biopsy instrument. The 2D patient images are generated using SPECT and/or XCT, and are updated periodically to show biopsy instrument position and progress.
