Berner U, Menzel C, Rinne D, Kriener S, Hamscho N, Döbert N, Diehl M, Kaufmann R, Grünwald F
Department of Nuclear Medicine, Hospital of the Johann Wolfgang Goethe-University, Frankfurt, Germany.
Q J Nucl Med. 2003 Jun;47(2):85-9.
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 [(18)F]fluorodeoxyglucose positron emission tomography ([(18)F]FDG-PET) for detecting or ruling out malignancy in these patients.
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 [(18)F]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).
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.
[(18)F]FDG-PET seems to be a useful tool in the diagnostic work-up of patients with suspected paraneoplastic syndrome.
副肿瘤综合征（PS）包含多种与潜在恶性肿瘤相关的临床症状和疾病。由于治疗方案不同，有必要与良性自身免疫性疾病进行鉴别。这种诊断挑战包括耗时且昂贵的方法，并且在许多情况下并不成功。本研究的目的是评估[（18）F]氟脱氧葡萄糖正电子发射断层扫描（[（18）F]FDG-PET）在这些患者中检测或排除恶性肿瘤的情况。
在这项回顾性研究中，1996年至2001年间，共有30例疑似PS的患者（男∶女 = 17∶13，平均年龄55岁，范围22 - 76岁）接受了[（18）F]FDG-PET检查。诊断包括红皮病、小脑变性、皮肌炎、多发性神经病等。将PET扫描结果与组织病理学（n = 14）、放射学及随访数据（平均随访3.6年，范围1 - 6年）进行比较。
30例患者中有7例（23%）检测到潜在恶性肿瘤。7例恶性肿瘤中有6例显示葡萄糖摄取明显增加。1例良性肿瘤导致示踪剂摄取增加，另1例PET阳性患者拒绝活检，在28个月的临床随访中未发现恶性肿瘤生长。其余21例葡萄糖摄取无异常的患者在其他诊断方法或后续临床随访中均未显示恶性肿瘤。
[（18）F]FDG-PET似乎是疑似副肿瘤综合征患者诊断检查中的一种有用工具。
