Application of F-FDGPET/CT in primary isolated pulmonary solitary fibrous tumor.

OBJECTIVE

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.

METHODS

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).

RESULTS

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.

CONCLUSION

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.