Positron Emission Tomography–Computed Tomography in Paraneoplastic Neurologic Disorders

Abstract

To evaluate the cancer detection rate of wholebody positron emission tomography-computed tomography (PET-CT) in a paraneoplastic neurologic context.

CSF complements serum for evaluating paraneoplastic antibodies and NMO-IgG

“…Seronegativity for paraneoplastic antibodies does not exclude a diagnosis of cancer, and testing for occult malignancy should proceed in highly suspicious cases. 5 The low positivity rates for most paraneoplastic antibodies in this study are consistent with their rarity, and reflects the ordering of this testing in patients with diverse neurologic presentations, where no cause has been established. 1 The more frequent detection of NMO-IgG and NMDA receptor antibody is consistent with the more narrow clinical contexts for ordering these 2 tests.…”

Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment

“…If findings on CT of the chest, abdomen, and pelvis are negative, 18 F-fluorodeoxyglucose-positron emission tomography or combined positron emission tomography and CT may identify the underlying tumor. 27,81 In some instances, the PNS and associated antibodies may sufficiently suggest a particular cancer to prompt diseasespecific imaging modalities such as mammography. If, despite these studies, no malignancy is identified, it has been recommended that clinical and radiographic surveillance be repeated every 3 to 6 months for 2 to 3 years.…”

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

“…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.…”

“…Three studies did not clearly describe the reference standard used in patients with negative 18 F-FDG PET/CT results and were not included in the quantitative analysis (29,30,36).…”

“…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).…”