title: 18F-FDG PET/CT Diagnosis of Bronchopulmonary Carcinoids Versus Pulmonary Hamartomas.
abstract: OBJECTIVE
  Radiological characterization of pulmonary tumors may be difficult and invasive. Needle biopsy may produce false-negative results. 18F-FDG PET/CT is an established noninvasive procedure for lung tumor characterization and staging. This study was aimed at differentiating bronchopulmonary carcinoids from hamartomas and typical from atypical bronchopulmonary carcinoids by means of 18F-FDG PET/CT.
  
  
  METHODS
  In a retrospective analysis of 118 patients, with surgically resected pulmonary carcinoid tumors and hamartomas, 87 of those selected had also undergone 18F-FDG PET/CT preoperatively and constituted the study population. To better assess the tracer accumulation, especially in small lesions, the 18F-FDG uptake (SUV) in the tumors was corrected for partial volume effect by applying recovery coefficients corresponding to the respective various specific tumor volumes, as extrapolated from those obtained from experiments in a NEMA phantom.
  
  
  RESULTS
  The SUVmax was higher in the pulmonary carcinoids (mean, 3.9) than in the hamartomas (mean, 1.4; P ≤ 0.00001) and higher in the subgroup of peripheral carcinoids than in hamartomas (P ≤ 0.00001). The SUVmax was similar for the atypical and typical carcinoids, 5.0 and 3.8, respectively, because of the large variation in the data (P = 0.11).
  
  
  CONCLUSIONS
  Using PET measurements of the 18F-FDG uptake (SUVmax) in the tumors, corrected for partial volume effects, it was possible to differentiate the carcinoids from the hamartomas, but the clinically more aggressive atypical carcinoids could not be differentiated from the typical carcinoids.
authors.affiliation: From the *Division of Radiography, Department of Clinical Science, Intervention, and Technology, Stockholm; †Department of Radiology, Karolinska University Hospital, Huddinge; ‡Division of Respiratory Medicine and Allergology, Department of Medicine, Karolinska University Hospital; §Department of Molecular Medicine and Surgery, Karolinska Institutet; ∥Department of Radiology, Karolinska University Hospital, Stockholm; ¶Department of Radiology, Oncology, and Radiation Science, Uppsala University; #Department of Radiology, Uppsala University Hospital, Uppsala; **Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet; ††Department of Nuclear Medicine, Karolinska University Hospital; and ‡‡Division of Medical Imaging and Technology, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Natalja
authors.initials: N
authors.lastname: Uhlén
authors.forename: Oscar
authors.initials: O
authors.lastname: Grundberg
authors.forename: Hans
authors.initials: H
authors.lastname: Jacobsson
authors.forename: Anders
authors.initials: A
authors.lastname: Sundin
authors.forename: Katalin
authors.initials: K
authors.lastname: Dobra
authors.forename: Alejandro
authors.initials: A
authors.lastname: Sánchez-Crespo
authors.forename: Rimma
authors.initials: R
authors.lastname: Axelsson
authors.forename: Karl-Gustaf
authors.initials: KG
authors.lastname: Kölbeck
mesh_terms: D000328:Adult; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging*; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006222:Hamartoma / Q000000981:diagnostic imaging*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18