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.

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-CT in the diagnosis of PH. Data and methods Patients diagnosed with PH who had undergone PET-CT from literature pertaining were retrospectively analyzed, which were cases of publications from the Cochrane Library, PubMed, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI) and Wanfang databases, from 2008 to June 2022. The other 20 cases of the collection were patients from our hospital from 2008 to June 2022. Patients’ symptoms, imaging characteristics of chest CT, PET-CT characteristics, the reason for PET-CT and the complications were analyzed. Results In this retrospective study, a total of 216 patients were diagnosed with PH and had been examined by PET-CT. 20 of the cases were patients of our hospital from January 2008 to June 2022. The other cases were collected from the literature. The mean diameter of most PH lesions is 1.7 ± 1.0 cm. The mean maximum standardized uptake value (SUVmax) of the PH lesions was 1.2 ± 1.1. Most of their SUVmax were lower than internationally recognized cut-off value (SUVmax = 2.5). PET-CT was superior to CT in the diagnosis of PH but there was a correlation of between CT diagnosis and PET-CT diagnosis for the PH lesions. In order to draw the Receiver operating characteristic (ROC), we selected 29 patients with a clear SUVmax value of their PH lesion, and 29 lung cancer patients with clear SUVmax value in our hospital were collected as a control group. ROC curve analysis showed that the area under curve (AUC) of SUVmax was 0.899, and the optimal diagnostic threshold was SUVmax > 2.65. PET-CT could distinguish PH from malignant lesions with a sensitivity of 89.66% by applying a SUVmax of 2.65 as a cut-off in this study. Conclusion PET-CT might be a useful tool to diagnose PH, which shows a better diagnostic sensitivity than CT. But PET-CT can not be used as a single diagnostic approach, which should be combined with other methods and the patients’ history to make the most correct diagnosis.