Abstract
1041
Learning Objectives 1. To review the pathophysiology and common presentations of central nervous system paraneoplastic disorders. 2. To discuss the common functional imaging patterns seen in CNS paraneoplastic disorders with FDG PET/CT. 3. To explain the added benefit of PET/CT in the evaluation of CNS paraneoplastic disorders.
At our institution, we have found that the majority of patients with known or suspected central nervous system paraneoplastic disorders have normal or equivocal brain MRI imaging. This can present a problem to the clinicians who are seeking to document objective abnormalities prior to potential treatment. With the addition of FDG PET/CT, we have found that these patients can often be fit into patterns typical for paraneoplastic disorders. The patterns include "typical" paraneoplastic disorders such as limbic encephalitis and cerebellar degeneration, but also include less common disorders such as paraneoplastic motor neuron disease, global encephalopathy, and paraneoplastic frontal hypometabolism. Whole brain imaging with FDG PET/CT can be a powerful tool to document central nervous system paraneoplastic disorders. Especially in the setting of an unknown or unsuspected primary neoplasm, FDG PET/CT can provide objective evidence of an underlying brain abnormality that can be fit into a recognizable pattern of disease. With the added imaging features on PET/CT, a diagnosis of a paraneoplastic central nervous system disorder can be more confidently made allowing for potential treatment and appropriate surveillance