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Rev Esp Med Nucl Imagen Mol. 2015 Jul-Aug;34(4):236-43. doi: 10.1016/j.remn.2015.02.006. Epub 2015 Apr 10.

[(18)F-FDG PET/CT in the evaluation of patients suspected of paraneoplastic neurological syndrome].

[Article in Spanish]

Author information

  • 1Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Ciudad Real, España. Electronic address: angarvice@yahoo.es.
  • 2Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
  • 3Servicio de Oncología Médica, Hospital Virgen de la Luz, Cuenca, España.
  • 4Servicio de Medicina Interna, Complejo Hospitalario de Albacete, Albacete, España.
  • 5Servicio de Neurología, Complejo Hospitalario de Toledo, Toledo, España.
  • 6Servicio de Neurología, Hospital de Puertollano, Ciudad Real, España.
  • 7Servicio de Neurología, Hospital la Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
  • 8Unidad de Investigación, Hospital General Universitario de Ciudad Real, Ciudad Real, España.

Abstract

OBJECTIVE:

This study aimed to determine the diagnostic impact of (18)F-FDG PET/CT based on the clinical features of paraneoplastic neurological syndrome (PNS).

MATERIAL AND METHODS:

Multicenter retrospective and longitudinal study of patients with suspicion of PNS. The clinical picture was classified into classic (CS) and non-classic syndrome (NCS). After the follow-up, the definitive or possible diagnosis of PNS was established. The pictures that did not match any of the previous criteria were categorized as non-classifiable. The state of the onco-neural antibodies was studied. The PET/CT was classified as positive or negative for the detection of malignancy. The relationship between PET/CT findings and the final diagnosis was determined. The differences between variables (Pearson test X(2)) and the relationship between the results of the PET/CT and the final diagnosis were analyzed.

RESULTS:

A total of 64 patients were analyzed, classifying 30% as CS and 42% as NCS. After the follow-up, 20% and 16% of subjects were diagnosed as possible and definitive PNS, respectively. Positive onco-neural antibodies were found in 13% of the patients. A definitive diagnosis of PNS was associated with a positive PET/CT (P=.08). A significant relation between antibodies expression and final diagnosis of neoplasia (P=.04) was demonstrated. The PET/CT correctly localized malignancy in 5/7 cases of invasive cancer.

CONCLUSIONS:

The PET/CT showed a higher percentage of positive results in patients with definitive diagnosis of PNS. Despite the low prevalence of malignancy in our series, the PET/CT detected malignancy in a significant proportion of patients with invasive cancer.

KEYWORDS:

(18)F-FDG; Clasificación clínica; Clinical classification; PET/CT; PET/TC; Paraneoplastic neurological syndrome; Síndrome paraneoplásico neurológico

PMID:
25864422
DOI:
10.1016/j.remn.2015.02.006
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