What is the role of imaging studies in the workup of paraneoplastic syndromes?

Updated: Jan 12, 2021
  • Author: Luigi Santacroce, MD; Chief Editor: Wafik S El-Deiry, MD, PhD  more...
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Any possible imaging study may be useful to detect the primary tumor in patients with paraneoplastic disorders, including the following:

  • Computed tomography (CT) and magnetic resonance image (MRI) scanning of the whole body allow detection of the site and the extension of the underlying primary tumor and its metastases, if present

  • Scintigraphy may be useful in patients with endocrine disorders related to a hormone-producing tumor

  • Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) scanning may be performed to evaluate patients with neurologic disorders; these examinations allow differentiation of paraneoplastic and nonparaneoplastic neurologic disorders; fluoro-deoxyglucose-PET (FDG-PET) scanning can visualize tumors as small as 6-8 mm anywhere in the body and may be positive when chest radiography and CT are negative [38]

  • Vatankulu and colleagues examined the accuracy of FDG-PET/CT and paraneoplastic antibodies in diagnosing cancer in a retrospective study of 42 patients with paraneoplastic neurological syndromes. PET/CT had 85.71% sensitivity, 100% specificity, 100% positive predictive value,and 97.22% negative predictive value for the detection of tumors, and was accurate in detecting underlying malignancy regardless of the presence of paraneoplastic antibodies. [50]

  • Kristensen and colleagues examined the clinical value of FDG-PET/CT in suspected paraneoplastic syndromes in a retrospective analysis of 137 patients.FDG-PET/CT had  75% sensitivity, 82% sepecificity, 29% positive predictive value, and 97% negative predictive value for ruling out paraneoplastic syndromes. [51]

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