Abstract: Objective: To elucidate the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FFDG PET/CT) for epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma. Methods: We retrospectively reviewed 117 pulmonary adenocarcinoma patients who underwent EGFR mutation testing after surgical treatment and pretreatment 18F-FDG PET/CT in Tianjin Medical University Cancer Hospital.The associations between the clinical characteristics of the patients, the maximal of SUV (SUVmax), the mean of SUV (SUVmean) and the peak of SUV (SUVpeak) of primary tumor, and the ratio between SUVmax of the primary tumor and the mediastinal blood pool to the EGFR mutation status were analyzed.Receiver operating characteristic (ROC) curve of different PET parameters were analyzed. Results: Among 117 patients, EGFR mutations were identified in 65 patients.The ratio of EGFR mutation is higher in non-smoking patients than in smoking patients (62.5% vs.40.5%, P=0.026).SUVmax, SUVmean, SUVpeak of primary tumor, and the ratio between SUVmax of the primary tumor and the mediastinal blood pool in patients with EGFR mutation were significantly lower than those of wild type (SUVmax:8.02±3.96 vs.10.31±5.80, P=0.017;SUVmean:4.97±2.51 vs.6.45±3.68, P=0.015;SUVpeak:6.03±3.22vs.8.06±5.01, P=0.013;T/N:5.08±3.01 vs.6.91±4.40, P=0.012).There was no significant difference in diagnostic efficiency between different diagnostic criteria. Conclusions: The FDG uptake value of primary tumor in patients with EGFR mutation is lower than that in wild type patients. Therefore, 18F-FDG PET/CT has some guiding significance for the assessment of EGFR mutation status in patients with primary adenocarcinoma. Keywords:18F-FDG, PET/CT, pulmonary adenocarcinoma, EGFR mutation