Role of FDG (18F) PET in paraneoplastic neurological syndromes

Paraneoplastic neurological syndromes (PNS) are rare non-metastatic manifestations of cancer. However, in this family of diseases, to recognize the underlying malignancy is an emergency. The ultimate aim is to treat the patient and try to stabilize or improve the neurological dysfunction, which is frequently the cause of the patient's death. The yield of FDG PET seems to be poor in unselected PNS. In the last decade, neurologists have attempted to provide more rigorous diagnostic criteria for PNS. Thus, "classical" PNS and a panel of "well-characterized" onconeural antibodies have been defined in order to facilitate triage of patients for whom FDG PET would be more sensitive. Currently, given the limited availability of PET cameras in France, this examination should be performed in the presence of either a "classical" PNS with or without onconeuralantibodies positivity or other PNS with onconeural antibodies positivity. The FOG PET should be triggered after a negative conventional imasing work up. (C) 2010 Elsevier Masson SAS. All rights reserved.