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Objective: To evaluate the clinical usefulness of fluorodeoxyglucose (FDG)-PET/CT in differentiation of solitary pulmonary nodule by comparison the 18F-FDG PET/CT results of 85 patients with pulmonary nodules with the corresponding pathology results.Methods: This retrospective study included 85 patients (50 men and 35 women; mean age, 57years).After at least a 4h fast, each patient received 18F-FDG injection intravenously with the dose 0.08-0.1mCi/kg.All subjects were instructed to rest comfortably for 60 min and to empty their bladders before scanning.Trunk 18F-FDG PET/CT images were obtained using a Gemini 16 scanner (Philips, Netherlands) as usual.All of the 1 8F-FDG PET/CT images were evaluated retrospectively, based on the consensus of two board-certified nuclear physicians with many years experience in the interpretation of clinical 18F-FDG PET/CT images who were blinded to the pathological results.The final pathology of all subjects were made by surgery or bronchoscopy.Results: According to pathological results, there were total 70 cases suffering lung cancer,including adenocarcinoma in 58cases (1 bronchioloalveolar carcinoma, and 4 well differentiated adenocarcinoma with bronchioloalveolar carcinoma), small cell lung cancer in 10 cases, squamous cell carcinoma in 14 cases, adenosquamous cell carcinoma in 1 case, and metastatic carcinoma in 3 cases.In these 70 cases of lung cancer, 69 cases were correctly diagnosed by PET/CT and 1 case of well differentiated adenocarcinoma with bronchioloalveolar carcinoma was misdiagnosed (false negative case).There were total 15 cases with benign diseases, including tuberculosis in 5 cases, lung abscess in 3 cases, sarcoidosis in 2 cases, hamartoma in 1 case, inflammatory pseudotumor in 1 case, and other inflammatory lesions in 3 cases.So, the accuracy, sensitivity and specificity of 18F-FDG PET/C for the differential diagnosis of solitary pulmonary nodule was 87.06% (74/85),98.57% (69/70) and 33.33% (5/15), respectively.and the false negative rate and the false positive rate was 1.43%(1/70) and 66.67% (10/15) , respectively.Conclusion: The sensitivity and accuracy of 18F-FDG PET/C for the differential diagnosis of solitary pulmonary nodule is rather high, but there are still relatively high false-positive rate for those benign disease with hypermetabolism, so it is necessary to combine clinical data and/or other imagings.