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Keywords:

  • 18F-FDG;
  • PET/CT;
  • pulmonary artery sarcoma;
  • pulmonary thromboembolism;
  • tumour embolism

Abstract

Background

The role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in evaluating pulmonary artery lesions has not yet been established. The purpose of this study is to evaluate the usefulness of 18F-FDG PET/CT imaging in differentiating malignant from benign pulmonary artery (PA) lesions.

Methods

In this retrospective study, 18 subjects with 26 low-attenuated filling defects suspicious for PA malignancy on contrast-enhanced chest CT were enrolled; all of whom subsequently underwent 18F-FDG PET/CT. The maximum standardized uptake value (SUVmax) for all PA lesions, defined as the 18F-FDG uptake, was measured. The final diagnosis was then determined by pathological findings, follow-up chest CT or clinical follow-up, and compared with the PET imaging.

Results

In total, 6 PA sarcomas, 5 tumour embolism, and 15 pulmonary thromboembolism (PTE) occurred in this cohort. Not only was the SUVmax of the malignant PA lesions (10.2 ± 10.8) was significantly higher than that associated with PTE (1.7 ± 0.3; P < 0.001), no overlap occurred between groups. Conversely, no statistically significant difference in SUVmax occurred between PA sarcomas (12.8 ± 14.7) and tumour embolism (7.0 ± 1.32; P = 1.000).

Conclusions

18F-FDG PET/CT is a useful imaging modality for differentiating malignant from benign PA lesions in patients with inconclusive low-attenuation filling defects on contrast-enhanced chest CT.