title: Accuracy of FDG-PET/CT and paraneoplastic antibodies in diagnosing cancer in paraneoplastic neurological syndromes.
abstract: OBJECTIVE
  There is still no consensus about whether to perform PET/CT to detect carcinoma in paraneoplastic neurological syndromes (PNS) in patients with or without antibodies. The aim of this study is to determine the diagnostic accuracy of PET/CT and antibodies in patients with PNS.
  
  
  METHODS
  A retrospective study was conducted on patients with clinically suspected PNS between 2008 and 2013. The association between histopathological findings, paraneoplastic antibodies, and PET/CT findings were evaluated. Sensitivity and specificity for the detection of underlying malignancy were calculated for PET/CT and paraneoplastic antibodies.
  
  
  RESULTS
  A total of 42 patients were analyzed. Of these 42 patients, 32 (75%) had a classical PNS, 6 (14%) had positive PET/CT findings, and 34 were tested for the presence of antibodies (anti-Hu Ab, anti-Yo Ab, and anti-Ri Ab). Twenty one of 34 patients had positive antibodies. Of the 6 patients with positive PET/CT findings, 6 had positive histopathological results. Among 21 patients with positive biomarkers, carcinoma was confirmed only in 5 patients. One patient with negative antibodies, but positive PET/CT findings, was diagnosed with a tumor. Gastric carcinoma was detected in 1 patient with negative PET/CT findings and antibodies during follow-up. Based on the results, PET/CT was found to have 85.71% sensitivity, 100% specificity, 100% positive and 97.22% negative predictive values in the detection of tumors.
  
  
  CONCLUSIONS
  PET/CT has a certain diagnostic accuracy for detecting underlying malignancy in patients with PNS, regardless of the presence of paraneoplastic antibodies.
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Nuclear Medicine, Istanbul, Turkey. Electronic address: bvatankulu@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Vatankulu
authors.affiliation: Yildirim Bayezit University, Ataturk Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Yilmaz Aksoy
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Nuclear Medicine, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Asa
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Nuclear Medicine, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Sager
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Nuclear Medicine, Istanbul, Turkey.
authors.forename: H B
authors.initials: HB
authors.lastname: Sayman
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Nuclear Medicine, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Halac
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Nuclear Medicine, Istanbul, Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Sonmezoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000912:Antibodies, Neoplasm / Q000097:blood*; D001323:Autoantibodies / Q000097:blood*; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging*; D051959:ELAV Proteins / Q000276:immunology; D005260:Female; D005462:Fluorine Radioisotopes / Q000032:analysis; D019788:Fluorodeoxyglucose F18 / Q000032:analysis; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000276:immunology; D000090682:Neuro-Oncological Ventral Antigen; D020361:Paraneoplastic Syndromes, Nervous System / Q000097:blood / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D016601:RNA-Binding Proteins / Q000276:immunology; D019275:Radiopharmaceuticals / Q000032:analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000912:Antibodies, Neoplasm; D001323:Autoantibodies; C095184:CDR2 protein, human; D051959:ELAV Proteins; D005462:Fluorine Radioisotopes; D009419:Nerve Tissue Proteins; D000090682:Neuro-Oncological Ventral Antigen; D016601:RNA-Binding Proteins; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Anticuerpos paraneoplásicos; Malignancy; Malignidad; Paraneoplastic antibodies; Paraneoplastic neurological syndrome; Positron emission tomography; Síndromes neurológicos paraneoplásicos; Tomografía por emisión de positrones