Multidetector Computed Tomography Findings in Pulmonary Hamartomas

A New Fat Detection Threshold

Abstract

Purpose: 

The aim of the study was to determine the accuracy of multidetector computed tomography in the evaluation of histologically confirmed pulmonary hamartomas (PHs), with a special focus on fat detection.

Materials and Methods: 

Data from 55 patients who had received a histologically confirmed diagnosis of PH and had undergone 64-slice thoracic MDCT were retrospectively evaluated.

Results: 

PHs manifested predominantly as peripheral pulmonary nodules with lobulated margins. The average lesion diameter was 1.51 cm (SD 0.6 cm). Histologic analyses identified fat content in 43/55 (78.2%) surgical specimens. The accuracy, sensitivity, and specificity of fat detection at a density threshold of −40 HU were 83.7%, 100%, and 87.2%, respectively. A threshold of −33 HU yielded better results (95.3%, 100%, and 96.3%, respectively). Popcorn-like calcifications were found in only 12/55 (21.8%) PHs and were the only imaging feature suggestive of PH in 7.2% of cases. Most (66%) lesions with popcorn-like calcifications also contained fat.

Conclusions: 

The adoption of a new threshold for fat content (<−33 HU) can lead to further improvements in the overall ability to detect PHs by CT.