¹⁸F-FDG PET/CT and contrast-enhanced CT in diagnosis of pulmonary sclerosing hemangioma

Objective: To evaluate the value and characteristics of ¹⁸F-FDG PET/CT and contrast enhanced CT in pulmonary sclerosing hemangioma (PSH). Methods: A retrospective study involving 5 patients confirmed as PSH by pathology from June 2007 to June 2011 was performed. The cases consisted of four women and one man with age ranged from 39 to 66 (mean 51.6) years. All patients received dual phase ¹⁸F-FDG PET/CT, high resolution (HR) CT and multi-phase contrast-enhanced CT (Siemens Bio graph 16 PET/CT). Lesion SUV_max on early and delayed PET/CT images, retention index, increased HU value, washout time from peak on contrast-enhanced CT and peritumor vessel sign were studied. Results: PSH lesions showed patchy increased ¹⁸F-FDG uptake with mean SUV_max on early and delayed PET/CT of 3.3 ± 1.1 and 3.4 ± 1.4, respectively. The mean retention index was (2.1 ± 20.8)%. The morphological features of PSH on HRCT included findings such as a round/oval nodule or mass with well-defined margins and air meniscus sign. On multi-phase contrast-enhanced CT, PSH showed moderate to high enhancement (the increased value: 35 to 59 HU) with washout times from peak of 140 to 260 s, and 1 to 4 peritumor vessel signs. Conclusions: A patchy pattern of high ¹⁸F-FDG uptake on PET/CT is suggestive of benign entity. Contrast-enhanced CT findings are very useful to increase the confidence for the diagnosis of PSH. (authors)