PET/CT and Paraneoplastic Syndromes: A Comprehensive Review

Motaz Daraghma; Yashant Aswani; Sanchay Jain; Riccardo Laudicella; Ali Gholamrezanezhad; Yusuf Menda; Ahmad Shariftabrizi

doi:10.3390/cancers17162637

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PET/CT and Paraneoplastic Syndromes: A Comprehensive Review

Journal article

Open access

Peer reviewed

PET/CT and Paraneoplastic Syndromes: A Comprehensive Review

Motaz Daraghma, Yashant Aswani, Sanchay Jain, Riccardo Laudicella, Ali Gholamrezanezhad, Yusuf Menda and Ahmad Shariftabrizi

Cancers, Vol.17(16), 2637

08/13/2025

DOI: 10.3390/cancers17162637

PMCID: PMC12384497

PMID: 40867266

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https://doi.org/10.3390/cancers17162637View

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Abstract

Paraneoplastic syndromes (PNSs) are pathologic conditions produced by neoplasms not attributable to tumor invasion or metastasis. The clinical manifestations of PNSs can precede the diagnosis; these symptoms may serve as early indicators of underlying malignancy. Standard imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), have limited sensitivity in detecting small or early-stage PNS-associated tumors. FDG PET/CT identifies hypermetabolic lesions suggestive of malignancy and, therefore, facilitates early diagnosis, refined treatment planning, and potentially prolonged patient survival. This review evaluates the diagnostic accuracy, clinical utility, and emerging role of FDG PET/CT in detecting occult malignancies. Syndrome-targeted applications discussed include limbic encephalitis, cerebellar degeneration, Lambert-Eaton myasthenic syndrome, Cushing’s syndrome, hypercalcemia of malignancy, dermatomyositis, and tumor-induced osteomalacia. In addition, the limitations of FDG PET/CT, including false-positive or false-negative findings, are reviewed, while newer PET tracers, like 68Ga-DOTATATE, are also highlighted. Ultimately, FDG PET/CT has transformed clinical decision-making, enabling more timely interventions and improved patient management in the context of PNSs. Future directions in imaging, including PET/MRI and ongoing refinements in tracer design, promise to further enhance diagnostic precision, and therapeutic outcomes are also discussed.

DOTATATE

FDG

metabolic imaging

occult malignancy detection

paraneoplastic symptoms

positron emission tomography

Details

Title: Subtitle: PET/CT and Paraneoplastic Syndromes: A Comprehensive Review
Creators: Motaz Daraghma - Saint Luke's Hospital
Yashant Aswani - University of Iowa
Sanchay Jain - University of Iowa
Riccardo Laudicella - University of Messina
Ali Gholamrezanezhad - University of Southern California
Yusuf Menda - University of Iowa
Ahmad Shariftabrizi - University of Iowa
Resource Type: Journal article
Publication Details: Cancers, Vol.17(16), 2637
DOI: 10.3390/cancers17162637
PMID: 40867266
PMCID: PMC12384497
NLM abbreviation: Cancers (Basel)
ISSN: 2072-6694
eISSN: 2072-6694
Publisher: MDPI
Language: English
Date published: 08/13/2025
Academic Unit: Radiology; Radiation Oncology
Record Identifier: 9984948137802771

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