18F-fluorodeoxyglucose positron emission tomography in the diagnosis of malignancy in patients with paraneoplastic neurological syndrome: a systematic review and meta-analysis

Vicente, Ana María García; Delgado-Bolton, Roberto; Amo-Salas, Mariano; López–Fidalgo, Jesús; Aróztegui, A.P. Caresia; Garzón, J.R. García; Rincón, J. Orcajo; Velloso, María José García; Torres, M.D. Martínez del Valle; Ruiz, S. Álvarez

doi:10.1007/s00259-017-3722-4

Cited by 24 publications

(9 citation statements)

References 25 publications

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“…The strengths of this study include a large heterogeneous patient cohort and long follow-up period. The cancer prevalence was 12.1%, which is similar with other studies [ Table 4 ],[ 7 8 9 10 11 12 13 14 15 ] although slightly higher than Kristensen et al who also excluded patients with previously diagnosed tumors from their group composition and reported a cancer prevalence of 8.8%. [ 7 ] Our prevalence may be in the higher range due to a greater proportion of suspected paraneoplastic syndrome cases (88% vs. 49%) and possibly higher pretest probability as other differentials were extensively investigated before the 18 F-FDG PET/CT scan was used.…”

Section: Discussionsupporting

confidence: 89%

“…Two recent meta-analyses have been published on the use of 18 F-FDG PET scan in suspected paraneoplastic syndrome. [ 14 15 ] The study published by Sheikhbahaei et al in recent systematic review and meta-analysis of 18 F-FDG PET and 18 F-FDG PET/CT in patients with paraneoplastic syndrome demonstrated a pooled sensitivity of 0.81, specificity of 0.88, and moderate diagnostic odds ratios (DOR). The area under the curve (AUC) of the summary receiver operating characteristic curve was 0.916.…”

Section: Discussionmentioning

confidence: 99%

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18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of suspected paraneoplastic syndromes: A retrospective analysis

et al. 2020

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Paraneoplastic syndromes are a rare clinical presentation of tumor thought to affect 0.01% of patients with cancer. Paraneoplastic syndromes present a diagnostic challenge as a wide variety of signs and symptoms may appear. This study examines the use of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) as a diagnostic imaging tool for detecting tumor in suspected paraneoplastic syndrome cases. This single-center retrospective study included patients with suspected paraneoplastic syndrome who underwent whole-body 18 F-FDG PET/CT scan between December 2005 and December 2016. Associated clinical data were gathered via electronic chart review. Patient records were reviewed for age, sex, clinical signs and symptoms, ancillary diagnostic procedures, date of diagnosis, and follow-up time. Ninety-nine patients met inclusion criteria for this study. Mean follow-up period was 1.8 years. Cancer prevalence was 12.1%. The 18 F-FDG PET/CT results are as follows: 10 true positives, 5 false positives, 82 true negatives, and 2 false negatives. The diagnostic values are as follows: sensitivity 83.3%, specificity 94.3%, positive predictive value 66.7%, and negative predictive value (NPV) 97.6%. The high NPV in our study supports the effectiveness of 18 F-FDG PET/CT to rule out tumor in suspected paraneoplastic syndrome. Future research aims to analyze which patients with suspected paraneoplastic syndrome would benefit most from 18 F-FDG PET/CT.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of suspected paraneoplastic syndromes: A retrospective analysis

et al. 2020

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“…Several studies have shown that whole-body [18F]FDG-PET and [18F]FDG PET/CT are very useful in the screening of patients with suspected paraneoplastic syndrome and positive paraneoplastic antibodies [ 12 ]. However, a recent study conducted by another group suggested that the presence of paraneoplastic antibody should not be an indispensable factor for performing [18F]FDG PET/CT [ 13 , 14 ]. In our study, the effectiveness of [18F]FDG PET/CT in the detection of pathology in patients with the presence and absence of onconeuronal antibodies was confirmed.…”

Section: Discussionmentioning

confidence: 99%

Additional Value of [18F]FDG PET/CT in Detection of Suspected Malignancy in Patients with Paraneoplastic Neurological Syndromes Having Negative Results of Conventional Radiological Imaging

Opalińska¹,

Sowa‐Staszczak

Wężyk

et al. 2022

JCM

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Background: Paraneoplastic neurological syndromes (PNS) affecting the CNS (central nervous system) are rare, presenting in less than 1% of all those with cancer. The pathogenesis of paraneoplastic neurological syndromes is not fully understood, but it is presumed to result from an immune attack on the underlying malignancy. The presence of different types of onconeural antibodies may occur in different tumors and can lead to different clinical manifestations, making the early detection of cancers challenging. Aim: An evaluation of [18F]FDG PET/CT in neoplastic tumor detection in patients with paraneoplastic neurological syndromes having negative or unremarkable results of conventional radiological imaging. Methods: Among all patients diagnosed with paraneoplastic neurological syndromes in the Neurology Department in 2016–2020, 15 patients with unremarkable conventional radiological findings who underwent [18F]FDG PET/CT were included in the study. Results: [18F]FDG PET/CT enabled localization of suspected malignancy in 53% (8 of 15) of PNS cases with previous unremarkable conventional radiological findings. Conclusion: [18F]FDG PET/CT may be considered as a useful tool for neoplastic tumor detection in patients with paraneoplastic neurological syndromes, accelerating the diagnostic process and enabling faster initiation of appropriate treatment.

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“…Imaging diagnosis of the primary malignancy in PNS is challenging; reports suggest that FDG‐PET is highly sensitive and specific for detection of occult malignancy, particularly in patients with hormone receptor negative tumors . Tumor size and grade are also important predictors of FDG‐PET performance, with more false negatives reported in patients with small, low‐grade tumors .…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic neurologic syndrome as a presentation of underlying breast malignancy

et al. 2018

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While breast cancer most commonly presents as a screen-detected mammographic finding or a breast symptom, in very rare instances it may first present as a paraneoplastic neurologic syndrome (PNS; Surg Case Rep, 2015;1:59; Ann Neurol 2004;56:715). Fewer than 1% of breast cancer patients have PNS, and an even smaller percentage initially present with neurologic symptoms (J Neurol Neurosurg Psychiatry, 2004;75:ii43). We report a case series of three patients who presented with neurological disorders suspicious for PNS, and were subsequently found to have underlying breast cancer. We follow this with a discussion of key clinical features of management considerations in paraneoplastic syndromes secondary to breast malignancy. K E Y W O R D Sbreast cancer, imaging, paraneoplastic neurologic syndrome

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18F-fluorodeoxyglucose positron emission tomography in the diagnosis of malignancy in patients with paraneoplastic neurological syndrome: a systematic review and meta-analysis

Abstract: The results of our meta-analysis reveal high diagnostic performance of FDG PET in the detection of malignancy responsible for PNS, not affected by the presence of onconeural antibodies or clinical characteristics.

Cited by 24 publications

References 25 publications

18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of suspected paraneoplastic syndromes: A retrospective analysis

18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of suspected paraneoplastic syndromes: A retrospective analysis

Additional Value of [18F]FDG PET/CT in Detection of Suspected Malignancy in Patients with Paraneoplastic Neurological Syndromes Having Negative Results of Conventional Radiological Imaging

Paraneoplastic neurologic syndrome as a presentation of underlying breast malignancy

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