, Available online , doi: 10.15953/j.ctta.2022.070
Abstract:
Objective: To explore the whole body 18F-FDGClinical value of PET/CT combined neuroantibody detection in the diagnosis and treatment of paraneoplastic neurological syndromes (PNS). Methods: Clinical, laboratory and imaging data of 56 hospitalized patients with suspected PNS who underwent systemic 18F-FDG PET/CT and neuropathic tumor antibody detection were retrospectively collected and followed up. ROC curve was performed to compare the diagnostic efficacy of PET/CT, neuronal antibody and the combined detection results of them. Results: Among the 56 patients with suspected PNS, there were 20 patients with malignant tumor, including 19 cases complicated with PNS and 1 patient with spinal cord metastasis which also lead to neurological symptoms. 18F-FDG PET/CT imaging indicated tumor or possible tumor in 23 cases, of which 20 cases were true positive, 3 cases were false positive (the follow-up results were reflux esophagitis, reactive bone changes, inflammatory lesions in neck), and the remaining 33 cases were true negative. The sensitivity, specificity and accuracy of PET/CT were 100%, 91.7% and 94.6%, respectively. There were 33 cases with positive neuroantibody, including 8 cases of tumor with PNS (3 cases with anti-Amphiphysin antibody encephalitis, 2 cases with anti-GABAb antibody encephalitis, 1 case with anti-Yo antibody encephalitis, and 2 cases with anti-Hu antibody encephalitis). There were 25 cases without tumor (10 cases with LGI1 antibody encephalitis, 3 cases with anti-amphiphysin antibody encephalitis, 1 case with anti-Hu antibody encephalitis, 3 cases with anti-GABAb antibody encephalitis, 3 cases with anti-Yo antibody encephalitis and 1 case with Anti-caspr2, 1 case with GAD65, 1 case with NMDA, 1case with PNMA and 1 case with SOX1 antibody (1 case each) 23 cases were negative (12 cases with tumor). The sensitivity, specificity and accuracy of neuronal antibody test were 40.0%, 30.6% and 33.9%, respectively. The sensitivity, specificity and accuracy of the combined detection were 100.0%, 33.3%, 57.1%, 50%, 94.4%, 78.6%, respectively. ROC analysis showed that AUC were 0.958 (P=0.000<0.05; 95% CI 0.904~1.000), 0.353 (P=0.070>0.05; 95% CI 0.199~0.506), 0.667 (P=0.040<0.05; 95% CI 0.528~0.806) and 0.672 (P=0.034<0.05; 95% CI 0.514~0.830). Conclusion: Whole body 18F-FDG PET/CT can be the first choice for noninvasive tumor screening in patients with suspected PNS.
YUAN L L, CHEN Q, QIAO Z, et al. Research on the application value of 18F-FDG PET/CT combined with neuronal antibody detection in the diagnosis and treatment of PNS patients[J]. CT Theory and Applications, 2022, 32(0): 1-7. DOI:10.15953/j.ctta.2022.070. (in Chinese)