Diagnosis value of 18 F-Fluoro-D-glucose positron emission tomography-computed tomography in pulmonary hamartoma

Abstract

Purpose: The diagnosis of pulmonary hamartoma (PH) based on computed tomography (CT) is a challenge, especially in patients with atypical imaging characteristics. This study was aimed at summarizing the imaging characteristic of 18F-Fluoro-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) in PH and exploring the application value of PET in the diagnosis of PH. Data and Methods: Patients diagnosed with PH who had undergone PET-CT from our hospital were retrospectively reviewed. And other cases were publications regarding the use of PET-CT in patients with PH were retrieved from the Cochrane Library, PubMed, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI) and Wanfang databases, until June 2022. Patients’ symptoms, imaging characteristics of chest CT, tumor markers, PET-CT characteristics, the reason for PET-CT and the complications were analyzed. Results: In this retrospective study, a total of 219 patients were diagnosed with PH and had been examined by PET-CT. 23 of the cases were patients of our hospital from January 2008 to June 2022. Others were collected from the literature. the mean diameter of most lung hamartoma lesions is 1.68 cm (0.4-5.5cm). Most of their SUVmax values were lower than internationally recognized cut-off value (SUVmax=2.5). PET-CT was superior to CT in diagnosing PH but there was a consistency of diagnostic efficiency between CT and PET-CT. ROC curve analysis showed that the AUC(Area under curve) of SUVmax was 0.905, and the optimal diagnostic threshold was SUVmax>2.65. Conclusion: PET-CT might be a useful tool to diagnose PH, even though with atypical radiographic features, and show better diagnostic accuracy than CT.