Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS Patients
Objective: To explore the clinical value of whole-body 18F-FDG PET/CT combined with 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 syst...
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| Format: | Article |
| Language: | English |
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Editorial Office of Computerized Tomography Theory and Application
2023-03-01
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| Series: | CT Lilun yu yingyong yanjiu |
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| Online Access: | https://www.cttacn.org.cn/cn/article/doi/10.15953/j.ctta.2022.070 |
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| author | Leilei YUAN Qian CHEN Zhen QIAO Xiaotong LI Di FAN Wei ZHANG Lin AI |
| author_facet | Leilei YUAN Qian CHEN Zhen QIAO Xiaotong LI Di FAN Wei ZHANG Lin AI |
| author_sort | Leilei YUAN |
| collection | DOAJ |
| description | Objective: To explore the clinical value of whole-body 18F-FDG PET/CT combined with 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 on. ROC curve analysis was performed to compare the diagnostic efficacy of PET/CT, neuronal antibodies, and their combined detection results. Results: Among the 56 patients with suspected PNS, there were 20 with malignant tumors, including 19 cases complicated with PNS and 1 patient with spinal cord metastasis which also le d to neurological symptoms. 18F-FDG PET/CT imaging indicated tumors or possible tumors 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, or inflammatory lesions in the 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 neuroantibodies, including 8 cases of tumors 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). Moreover, there were 25 cases without tumors (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, 1 case with Anti-caspr2, 1 case with GAD65, 1 case with NMDA, 1 case with PNMA, and 1 case with SOX1 antibody (1 case each). Of these, 23 cases were negative (12 cases with tumor). The sensitivity, specificity, and accuracy of the neuronal antibody test were 40.0%, 30.6%, and 33.9%, respectively. Furthermore, the sensitivity, specificity, and accuracy of the combined detection were 100.0%, 33.3%, 57.1%, 50%, 94.4%, and 78.6%, respectively. ROC analysis showed that the AUC was 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 has the potential to be the first choice for noninvasive tumor screening in patients with suspected PNS. |
| first_indexed | 2024-03-12T22:51:02Z |
| format | Article |
| id | doaj.art-6b4317027910409c98edc88b34c051c1 |
| institution | Directory Open Access Journal |
| issn | 1004-4140 |
| language | English |
| last_indexed | 2024-03-12T22:51:02Z |
| publishDate | 2023-03-01 |
| publisher | Editorial Office of Computerized Tomography Theory and Application |
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| series | CT Lilun yu yingyong yanjiu |
| spelling | doaj.art-6b4317027910409c98edc88b34c051c12023-07-20T08:57:31ZengEditorial Office of Computerized Tomography Theory and ApplicationCT Lilun yu yingyong yanjiu1004-41402023-03-0132220921510.15953/j.ctta.2022.0702022.070Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS PatientsLeilei YUAN0Qian CHEN1Zhen QIAO2Xiaotong LI3Di FAN4Wei ZHANG5Lin AI6Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, ChinaObjective: To explore the clinical value of whole-body 18F-FDG PET/CT combined with 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 on. ROC curve analysis was performed to compare the diagnostic efficacy of PET/CT, neuronal antibodies, and their combined detection results. Results: Among the 56 patients with suspected PNS, there were 20 with malignant tumors, including 19 cases complicated with PNS and 1 patient with spinal cord metastasis which also le d to neurological symptoms. 18F-FDG PET/CT imaging indicated tumors or possible tumors 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, or inflammatory lesions in the 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 neuroantibodies, including 8 cases of tumors 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). Moreover, there were 25 cases without tumors (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, 1 case with Anti-caspr2, 1 case with GAD65, 1 case with NMDA, 1 case with PNMA, and 1 case with SOX1 antibody (1 case each). Of these, 23 cases were negative (12 cases with tumor). The sensitivity, specificity, and accuracy of the neuronal antibody test were 40.0%, 30.6%, and 33.9%, respectively. Furthermore, the sensitivity, specificity, and accuracy of the combined detection were 100.0%, 33.3%, 57.1%, 50%, 94.4%, and 78.6%, respectively. ROC analysis showed that the AUC was 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 has the potential to be the first choice for noninvasive tumor screening in patients with suspected PNS.https://www.cttacn.org.cn/cn/article/doi/10.15953/j.ctta.2022.070fdgpet/ctparaneoplastic syndromeparaneoplastic antibody |
| spellingShingle | Leilei YUAN Qian CHEN Zhen QIAO Xiaotong LI Di FAN Wei ZHANG Lin AI Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS Patients CT Lilun yu yingyong yanjiu fdg pet/ct paraneoplastic syndrome paraneoplastic antibody |
| title | Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS Patients |
| title_full | Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS Patients |
| title_fullStr | Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS Patients |
| title_full_unstemmed | Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS Patients |
| title_short | Research on the Application Value of 18F-FDG PET/CT Combined with Neuronal Antibody Detection in the Diagnosis and Treatment of PNS Patients |
| title_sort | research on the application value of 18f fdg pet ct combined with neuronal antibody detection in the diagnosis and treatment of pns patients |
| topic | fdg pet/ct paraneoplastic syndrome paraneoplastic antibody |
| url | https://www.cttacn.org.cn/cn/article/doi/10.15953/j.ctta.2022.070 |
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