The Utility of FDG-PET/CT in Clinically Suspected Paraneoplastic Neurological Syndrome:A Literature Review and Retrospective Case Series

Maskery, Mark and Hill, Jonathan and Cain, John R. and Emsley, Hedley (2017) The Utility of FDG-PET/CT in Clinically Suspected Paraneoplastic Neurological Syndrome:A Literature Review and Retrospective Case Series. Frontiers in Neurology, 8.

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Abstract

Paraneoplastic neurological syndrome (PNS) describes a spectrum of rare, heterogeneous neurological conditions associated with an underlying malignancy. Diagnosis of PNS is inherently difficult, with frequent misdiagnosis and delay. The literature suggests an underlying immune-mediated pathophysiology, and patients are usually tested for the presence of onconeural antibodies. With direct tumor therapy being the most effective method of stabilizing patients, there is a strong emphasis on detecting underlying tumors. The sensitivity of conventional CT imaging is often inadequate in such patients. While FDG-PET imaging has already been shown to be effective at detecting these tumors, FDG-PET/CT, combining both structural and functional imaging in a single study, is a more recent technique. To study the utility of FDG-PET/CT, we conducted a systematic literature review and a retrospective study. We identified 41 patients who underwent imaging for clinically suspected PNS at the regional PET-CT and neurosciences center based at the Royal Preston Hospital between 2007 and 2014 and compared the results to conventional investigations. Five patients had FDG-PET/CT tracer avidity suspicious of malignant disease, and four of these were subsequently diagnosed with cancer. Sensitivity and specificity were calculated to be 100 and 97.3%, respectively, with positive predictive value 80% and negative predictive value 100%. This compares to a sensitivity and specificity of 50 and 100%, respectively, for CT and 50 and 89%, respectively, for onconeural antibodies. These findings are in line with previous studies and support the diagnostic accuracy of FDG-PET/CT for the detection of underlying malignancy.

Item Type: Journal Article
Journal or Publication Title: Frontiers in Neurology
Uncontrolled Keywords: /dk/atira/pure/subjectarea/asjc/2800/2808
Subjects:
Departments: Faculty of Health and Medicine > Medicine
ID Code: 87043
Deposited By: ep_importer_pure
Deposited On: 13 Jul 2017 10:24
Refereed?: Yes
Published?: Published
Last Modified: 30 Sep 2019 20:19
URI: https://eprints.lancs.ac.uk/id/eprint/87043

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