Is PET/CT Useful in Detecting Pneumocystis jirovecii Colonization in Patients with Primary Lung Cancer?

Background/Objectives: Pneumocystis jirovecii colonization induces persistent low-grade pulmonary inflammation, which may alter fluorodeoxyglucose (FDG) uptake in positron emission tomography/computed tomography (PET/CT). We aimed to evaluate whether asymptomatic infection influences the maximum standardized uptake value (SUVmax) or clinicopathological parameters of primary lung cancer.

Methods

In this prospective single-center observational study, 107 consecutive patients undergoing surgical resection for primary lung cancer were enrolled. Preoperative FDG PET/CT scans were obtained within four weeks prior to surgery. Intraoperative respiratory secretions and lung tissue samples were analyzed for P. jirovecii, using nested polymerase chain reaction (nested-PCR) targeting the mitochondrial large subunit rRNA gene. Propensity score matching (PSM) adjusting for age, sex, and body mass index was performed across 1:1, 1:2, and 1:3 matching models.