A Frequently Missed Pulmonary Infarction: Clinical and 18F-FDG PET/CT Manifestation of Hilar Tumor–Induced Pulmonary Infarction. (15th June 2022)

• Record Type: Journal Article
• Authors: Ji, Yu; Wang, Yaru; Shao, Chunchun; Cui, Yong; Su, Na; Shao, Guangrui; Zheng, Jingsong
• Is Part Of: Clinical nuclear medicine. Volume 47:Number 6(2022)
• Page Start: 473
• Page End: 479
• Publication Date: 2022-06-15
• Subjects: 18F-FDG -- hilar tumor -- PET/CT -- pulmonary infarction; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000004180
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: This study aimed to summarize the clinical and 18 F-FDG PET/CT manifestations of hilar tumor–induced pulmonary infarction. Methods: A retrospective analysis was performed on patients with hilar masses who underwent FDG PET/CT scans between July 2015 and January 2021 and had complete clinical data. Pulmonary infarction was confirmed by concurrent chest CT and imaging follow-up or pathology. Results: A total of 58 patients (mean age, 56 [SD, 13] years; 44 males) with 122 infarcts were included in the study. Hilar masses were mostly associated with small cell lung cancer (64%). The most common clinical manifestations were cough (64%) and hemoptysis (36%). Most patients (62%) had multiple pulmonary infarcts. The CT findings of pulmonary infarcts included the "Hampton hump" (48%) and patchy consolidation (52%). The density of infarcts included "bubbly consolidation" (61%) and "homogenous consolidation" (39%). The metabolic activity of 95 infarcts (78%) was higher than lung parenchyma, with the SUVmax of 3.3 (SD, 1.1). The metabolic patterns on PET/CT were "rim sign, " "mismatch between PET and CT, " and "no metabolism." Pulmonary vein involvement was found in 25 patients (43%), pleural effusion in 22 patients (38%), and the pleural curvilinear sign in 8 patients (14%). Conclusions: The clinical manifestations of hilar tumor–induced pulmonary infarction are not specific, and 18 F-FDG PET/CT could be an effective diagnostic tool.