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18F-FDG-PET/CT in the diagnosis of paraneoplastic neurological syndromes: a retrospective analysis

  • Molecular Imaging
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Abstract

Objectives

Paraneoplastic neurological syndromes (PNS) constitute a challenging diagnostic problem, as the underlying tumour often remains unidentified for a long time, even with frequent conventional diagnostic procedures. For appropriate patient management timely identification of the tumour is critical. We evaluated the value of 18F-FDG-PET/CT in the investigation of PNS.

Methods

The case notes of 46 consecutive patients with clinically suspected PNS who underwent 18F-FDG-PET/CT were reviewed retrospectively and the performance of PET/CT for detecting underlying tumours was assessed.

Results

PET/CT detected foci of increased 18F-FDG uptake in 10 out of 46 patients. In six of these 10 patients combined PET/CT identified the underlying disease: four patients suffered from PNS; vasculitic and local metastatic disease was detected in two other patients.

Conclusions

Based on our results, we believe that the role of positron emission tomography in the detection of occult neoplasms in patients with PNS has been overestimated in the past. In clinical practice, PNS is far more often suspected than proven. In our study combined PET/CT identified malignancy as the underlying cause of suspected PNS in only 8.7% (4/46). We believe that combined PET/CT should be reserved for stringently selected patients with a high clinical index of suspicion for PNS and after conventional imaging techniques fail to detect a tumour.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg-Eppendorf, Germany

    Peter Bannas, Christoph Weber & Gerhard Adam

  2. Department of Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Thorsten Derlin, Jörg Lambert, Janos Mester & Susanne Klutmann

  3. Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Frank Leypoldt

Authors
  1. Peter Bannas
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  2. Christoph Weber
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  3. Thorsten Derlin
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  4. Jörg Lambert
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  5. Frank Leypoldt
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  6. Gerhard Adam
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  7. Janos Mester
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  8. Susanne Klutmann
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Correspondence to Peter Bannas.

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Bannas, P., Weber, C., Derlin, T. et al. 18F-FDG-PET/CT in the diagnosis of paraneoplastic neurological syndromes: a retrospective analysis. Eur Radiol 20, 923–930 (2010). https://doi.org/10.1007/s00330-009-1606-0

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  • DOI: https://doi.org/10.1007/s00330-009-1606-0

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