18F-FDG PET/CT features of pulmonary sclerosing hemangioma

  • Eugene Lee
    Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul
  • Chang Min Park
    Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul
  • Keon Wook Kang
    Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul
  • Jin Mo Goo
    Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul
  • Min A Kim
    Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
  • Jin Chul Paeng
    Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul
  • Hyun Ju Lee
    Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul
  • Heae Surng Park
    Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
  • Doo Hyun Chung
    Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

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<jats:sec><jats:title>Background</jats:title><jats:p> Pulmonary sclerosing hemangioma (PSH) has been reported to show increased FDG uptake and be potential false-positives on 18F-FDG PET/CT examination. However, it is still unclear whether the previously-reported high FDG uptake is a universal characteristic of PSH, and furthermore, there have been no investigations on what kind of radiologic or histologic features may have been related with its FDG uptake values. </jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p> To investigate the 18F-FDG PET/CT features of pulmonary sclerosing hemangiomas (PSHs), and to evaluate the relating factors with their FDG uptake values. </jats:p></jats:sec><jats:sec><jats:title>Material and Methods</jats:title><jats:p> We identified 10 PSHs in eight patients who had a pathologic diagnosis and available antecedent 18F-FDG PET/CT images. 18F-FDG PET/CT images were investigated both qualitatively and quantitatively, along with their histopathologic features. Correlation between 18F-FDG PET features and radiologic as well as histopathologic features were also evaluated. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Mean diameter of the 10 PSHs in our study was 16.9 mm ± 6.26 (range 5-25 mm). Four tumors showed intense uptake, and four tumors showed moderate uptake on 18F-FDG PET/CT scans. In the remaining two tumors, there were no significant FDG uptakes. The SUVmax of tumors ranged from 0.60-4.7 (median 2.30; 2.51 ± 1.42), and was significantly correlated with the tumor size (r = 0.754, P = 0.012) and three out of four tumors ≥2 cm (75%) showed intense FDG uptake and their SUVmax values were greater than 2.5. Immunohistochemical results for GLUT-1, GLUT-4, and Ki-67 and other pathologic features were not correlated with the tumors’ FDG uptake. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> The majority of PSHs show increased FDG uptakes, and their SUVmax values are significantly correlated with their tumor size. PSH ≥2 cm can frequently be falsely interpreted as malignancy in FDG-PET/CT. Further studies with large study population are warranted to confirm our observations. </jats:p></jats:sec>

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