Utility of F-18 FDG PET/CT in Screening for Paraneoplastic Neurological Syndromes

Abstract

PET/CT may be a useful screening tool for patients with clinically suspected PNS who do not exhibit well-characterized paraneoplastic antibodies. Therefore, we recommended that PET/CT should be performed for patients with clinically suspicious PNS regardless of the presence of well-characterized paraneoplastic antibodies.

Utility of 18F-FDG-PET/CT in patients suspected of paraneoplastic neurological syndrome: importance of risk classification

“…Indeed, previous studies have reported on the usefulness of 18 F-FDG-PET in PNS, but its accuracy seems to be related to the pre-test probability [9][10][11][12][13][14][15][16][17][18][19][20]. Nevertheless, only Vaidyanathan et al [21] evaluated PET/CT in terms of pre-test clinical probability and its relation to the final detection of malignancy.…”

Whole-Body 18F-FDG PET and 18F-FDG PET/CT in Patients with Suspected Paraneoplastic Syndrome: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

“…Over the last decade, more studies have investigated the application of combined 18 F-FDG PET/CT in the initial evaluation and diagnosis of paraneoplastic syndromes and occult malignancy (3,5,(14)(15)(16)(17). In our study, the subgroup analysis by imaging modality revealed that 18 F-FDG PET/CT showed a significantly higher specificity than 18 F-FDG PET alone.…”

“…The details of the study design, patient demographics and characteristics, paraneoplastic presentation, paraneoplastic antibody status, index test, proportion of patients diagnosed with underlying malignancy, and reference standards of each included study were summarized in Supplemental Tables 2 and 3 (3,5,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(28)(29)(30)(31). Among the 24 studies included in the qualitative assessment, 4 studies were prospective and 20 studies were retrospective.…”

“…To assess the eligibility of the remaining 36 records, we retrieved the corresponding full texts or contacted the study authors inquiring about more information. Ultimately, a total of 24 studies were included in the qualitative assessment, and 21 studies met our predefined criteria to be included in the quantitative analysis (3,5,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37).…”

“…18 F-FDG PET and 18 F-FDG PET/CT have emerged as practical imaging modalities that allow for the detection of metabolically active tumors (6). Several studies have attempted to address the role of whole-body 18 F-FDG PET and 18 F-FDG PET/CT in the workup of patients with suspected paraneoplastic manifestations (3,5,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Although some of these studies have shown promising results, they were mostly conducted in relatively small and preselected patient populations.…”