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The Quarterly Journal of Nuclear Medicine 2003 June;47(2):85-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Paraneoplastic syndromes: detection of malignant tumors using [18F]FDG-PET

Berner U. 1, Menzel C. 1, Rinne D. 2, Kriener S. 3, Hamscho N. 1, Döbert N. 1, Diehl M. 1, Kaufmann R. 2, Grünwald F. 1

1 Department of Nuclear Medicine Hospital of the Johann Wolfgang Goethe-University Frankfurt, Germany 2 Department of Dermatology Hospital of the Johann Wolfgang Goethe-University Frankfurt, Germany 3 Department of Pathology Hospital of the Johann Wolfgang Goethe-University Frankfurt, Germany


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Aim. Paraneoplastic syndromes (PS) comprise a variety of clinical symptoms and diseases associated with underlying malignancy. Differentiation towards benign autoimmune diseases is necessary due to different therapeutic options. This diagnostic challenge includes cost- and time-consuming methods and is not successful in many cases. The aim of this study was the evaluation of [18F]fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) for detecting or ruling out malignancy in these patients.
Methods. In this retrospective work-up a total of 30 patients with suspected PS (m:f = 17:13, mean age 55, range 22-76 years) were examined with [18F]FDG-PET between 1996 and 2001. Diagnoses were erythrodermia, cerebellar degeneration, dermatomyositis, polyneuropathia and others. PET scans were compared to histopathological (n=14), radiological and follow up data (mean follow up 3.6 years, range 1-6 years).
Results. In 7 out of 30 patients (23%) an underlying malignancy was detected. Six out of 7 malignant neoplasms showed a distinctly increased glucose consumption. One benign neoplasm caused increased tracer uptake, another PET positive patient refused biopsy and showed no growth of a malignant tumour during clinical follow up of 28 months. The remaining 21 patients without suspicious glucose consumption did not demonstrate a malignancy in other diagnostic modalities or during subsequent clinical follow-up.
Conclusion. [18F]FDG-PET seems to be a useful tool in the diagnostic work-up of patients with suspected paraneoplastic syndrome.

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