title: 18F-FDG PET/CT and contrast-enhanced CT findings of pulmonary cryptococcosis.
abstract: OBJECTIVE
  Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules in non-AIDS patients. This study reports the18F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET/CT) and contrast-enhanced CT (CE-CT) findings of 42 patients with pulmonary cryptococcosis.
  
  
  METHODS
  A retrospective review of the18F-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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China. Electronic address: wang_shuxia@outlook.com.
authors.forename: Si-Yun
authors.initials: SY
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China. Electronic address: cgggh@outlook.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China. Electronic address: 695532870@qq.com.
authors.forename: Dong-Lan
authors.initials: DL
authors.lastname: Luo
authors.affiliation: Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China. Electronic address: shaodan501@outlook.com.
authors.forename: Dan
authors.initials: D
authors.lastname: Shao
authors.affiliation: Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China. Electronic address: GDGH2015@gmail.com.
authors.forename: En-Tao
authors.initials: ET
authors.lastname: Liu
authors.affiliation: Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China. Electronic address: sunmoodsdaisy@bjmu.edu.cn.
authors.forename: Taotao
authors.initials: T
authors.lastname: Sun
authors.affiliation: Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China. Electronic address: wsyggh@outlook.com.
authors.forename: Shu-Xia
authors.initials: SX
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003453:Cryptococcosis / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016867:Immunocompromised Host; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D064847:Multimodal Imaging / Q000379:methods; D055613:Multiple Pulmonary Nodules; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Cryptococcosis; Fluorodeoxyglucose F18; Multidetector computed tomography; Positron-emission tomography