18 F-FDG PET/CT and contrast-enhanced CT findings of pulmonary cryptococcosis

• DOI: 10.1016/j.ejrad.2017.02.008
• Publication Date: 2017-02-07T01:01:55Z
• Authors: Si-yun Wang; Gang Chen; Dong-lan Luo; Dan Shao; En-tao Liu; Taotao Sun; Shu-Xia Wang
• Keywords: Adult; Male; Adolescent; Lung Diseases, Fungal; Cryptococcosis; Middle Aged; Multimodal Imaging; 3. Good health; Immunocompromised Host; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Multidetector Computed Tomography; Humans; Multiple Pulmonary Nodules; Female; Radiopharmaceuticals; Aged; Retrospective Studies

Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules in non-AIDS patients. This study reports the 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET/CT) and contrast-enhanced CT (CE-CT) findings of 42 patients with pulmonary cryptococcosis.A retrospective review of the 18F-FDG PET/CT and CE-CT findings of 42 patients with histologically proven pulmonary cryptococcosis was conducted. All patients underwent PET/CT and CE-CT in the same session. The CT diagnosis was based on the location, morphological features, and enhancement of lesions. The PET/CT findings were recorded, and clinical data and surgical and histopathological findings were collected.The results of the PET scans revealed that 37 (88%) of 42 patients showed higher FDG uptake, and 5 (12%) patients demonstrated lower FDG uptake than the mediastinal blood pool. The maximum standardized uptake value (SUV) of pulmonary cryptococcosis ranged from 1.4 to 13.0 (average: 5.7±3.3, median 4.9). A single nodular pattern was the most prevalent pattern observed and was found in 29 (69%) patients. This pattern was followed by scattered nodular (n=4, 10%), clustered nodular (n=3, 7%), mass-like (n=3, 7%), and bronchopneumonic (n=3, 7%) patterns. The most frequent pattern of immunocompetent patients was the single nodular pattern (29 of 33, 88%). Immunocompromised patients most frequently pattern exhibited mass-like (3 of 9, 33%) and bronchopneumonic (3 of 9, 33%) patterns.Pulmonary cryptococcosis most commonly appears as single nodules in immunocompetent patients. Mass-like and bronchopneumonic patterns were common in immunocompromised patients. In 88% of patients, lung lesions showed high FDG uptake, thus mimicking a possible malignant condition.