Shao Mingyan, Fan Sisi, Qi Wanling
Department of Nuclear Medicine, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
Department of Pathology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
Front Med (Lausanne). 2025 Apr 17;12:1552628. doi: 10.3389/fmed.2025.1552628. eCollection 2025.
Pulmonary solitary fibrous tumors (SFTs) represent a rare clinical entity, with malignant variants demonstrating particularly aggressive behavior and metastatic potential. The diagnostic challenge in early-stage disease underscores the need for improved detection methods. This study evaluates the diagnostic utility of F-FDG PET/CT in distinguishing benign from malignant pulmonary SFTs and assesses its role in treatment response monitoring.
We performed a retrospective analysis of clinical characteristics and imaging findings in four histologically confirmed pulmonary SFT cases evaluated with F-FDG PET/CT at Jiangxi Provincial People's Hospital (2020-2024).
The cohort exhibited heterogeneous clinical presentations: three patients reported chest tightness with pain, one had non-painful chest tightness, and two presented with concomitant cough. Notably, no cases demonstrated hemoptysis, productive sputum, or fever. Contrast-enhanced CT initially suggested malignancy in three cases and benign pathology in one. PET/CT revealed two cases with intense FDG avidity (preoperatively classified as malignant-one with peritoneal metastases) and two with minimal uptake (classified as benign). Histopathological confirmation of all surgical specimens established PET/CT's 100% diagnostic accuracy for benign/malignant differentiation, compared to only 50% accuracy for contrast-enhanced CT.
F-FDG PET/CT provides clinically valuable discrimination between benign and malignant pulmonary SFTs, while offering additional benefits in disease staging, biopsy guidance, treatment response assessment, and post-therapeutic surveillance.
肺孤立性纤维瘤（SFTs）是一种罕见的临床实体，恶性变体表现出特别侵袭性的行为和转移潜能。早期疾病的诊断挑战凸显了改进检测方法的必要性。本研究评估F-FDG PET/CT在区分良性与恶性肺SFTs中的诊断效用，并评估其在治疗反应监测中的作用。
我们对江西省人民医院（2020 - 2024年）4例经组织学证实的接受F-FDG PET/CT检查的肺SFT病例的临床特征和影像学表现进行了回顾性分析。
该队列表现出异质性的临床表现：3例患者报告有胸痛伴胸闷，1例有非疼痛性胸闷，2例伴有咳嗽。值得注意的是，没有病例出现咯血、咳痰或发热。对比增强CT最初提示3例为恶性，1例为良性病变。PET/CT显示2例FDG摄取强烈（术前分类为恶性 - 1例有腹膜转移），2例摄取极少（分类为良性）。所有手术标本的组织病理学证实显示，PET/CT对良性/恶性鉴别诊断的准确率为100%，而对比增强CT的准确率仅为50%。
F-FDG PET/CT在区分良性与恶性肺SFTs方面提供了具有临床价值的鉴别，同时在疾病分期、活检指导、治疗反应评估和治疗后监测方面具有额外的益处。
