Imaging of Lung Hamartomas by Multidetector Computed Tomography and Positron Emission Tomography
Imaging of Lung Hamartomas by Multidetector Computed Tomography and Positron Emission Tomography
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DOI：
10.1016/j.athoracsur.2008.08.033
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发表时间：
2008-12-01
影响因子：
4.6
通讯作者：
Paganelli, Giovanni
中科院分区：
文献类型：
--
作者：
De Cicco, Concetta;Bellomi, Massimo;Paganelli, Giovanni
背景。错构瘤占孤立性肺结节的 8%，占良性结节的 75%。大多数是在常规 X 射线胶片上发现的，需要进一步评估。计算机断层扫描 (CT) 不足以对约 30% 的病例进行良恶性诊断。方法。我们回顾性评估了对比CT和[F-18]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）在42个连续病理证实的错构瘤中诊断非恶性肿瘤的能力，目的是减少未来病例中侵入性手术的数量。根据一位放射科医生的主观评估，计算机断层扫描被评估为可能良性或可能恶性。根据相对于正常实质和纵隔的摄取来评估 PET/CT 图像。结果。计算机断层扫描在 26 例 (62%) 中可能是良性的，在 16 例 (38%) 中可能是恶性的。 PET/CT 扫描结果显示良性 34 例（81% [16 例可用标准摄取值：平均值 1.1，SD 0.5]），可疑 4 例（9.5%），恶性 4 例（9.5%）。 PET/CT 检测的 34 个良性结节的平均大小为 14.3 毫米 (SD 7.8)，而 PET/CT 检测的 8 个恶性/可疑结节的平均大小为 22.7 毫米 (SD 10)。在这8个结节中，CT显示6个可能是良性的，2个可能是恶性的；因此CT和PET/CT仅2例一致为恶性肿瘤。结论。本研究是第一项专门关注经病理证实的一系列肺错构瘤的 CT 和 PET/CT 特征的研究。我们的研究结果支持 PET/CT 在表征孤立性肺结节中的作用，尽管约 20% 的错构瘤（主要是大尺寸）具有提示恶性肿瘤的摄取特征。
Background. Hamartomas constitute 8% of solitary lung nodules and 75% of benign nodules. Most are discovered on routine x-ray film and require further evaluation. Computed tomography (CT) is insufficient for a benign versus malignant diagnosis in about 30% of cases.Methods. We retrospectively assessed the ability of CT with contrast and [F-18] fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) to diagnose nonmalignancy in 42 consecutive pathologically confirmed hamartomas, with the aim of reducing the number of invasive procedures in future cases. Computed tomography was assessed as probably benign or probably malignant based on one radiologist's subjective evaluation. The PET/CT images were assessed according to uptake relative to normal parenchyma and mediastinum.Results. Computed tomography was probably benign in 26 cases (62%) and probably malignant in 16 (38%). The PET/CT scan was benign in 34 cases (81% [standard uptake value available in 16: mean 1.1, SD 0.5]), suspicious in 4 (9.5%), and malignant in 4 (9.5%). The 34 nodules benign by PET/CT had mean size 14.3 mm (SD 7.8) compared with mean 22.7 mm (SD 10) in the 8 nodules malignant/suspicious by PET/CT. Of these 8 nodules, 6 were probably benign by CT and 2 were probably malignant; thus CT and PET/CT concurred on malignancy in only 2 cases.Conclusions. The present study is the first specifically concerned with the CT and PET/CT characteristics of a pathologically confirmed series of lung hamartomas. Our findings support the role of PET/CT in characterizing solitary lung nodules, although about 20% of (mainly large size) hamartomas had uptake characteristics suggesting malignancy.