Brief observationsConventional Cancer Screening versus PET/CT in Dermatomyositis/Polymyositis
Section snippets
Patients
The study included 55 consecutive adult white patients who were recently diagnosed with dermatomyositis/polymyositis, consulting at 3 tertiary teaching hospitals in Barcelona (Vall d'Hebron General Hospital, Bellvitge Hospital, and Hospital Clinic) between February 2006 and January 2009. Altogether, these referral hospitals have 2500 beds for a catchment population of approximately 2.5 million inhabitants. Patients included in the study gave informed written consent to undergo FDG-PET/CT. The
Results
Between February 2006 and January 2009, 55 consecutive patients, 37 women and 18 men, with a median (interquartile range) age of 57.5 (46.1-68.9) years, were diagnosed with inflammatory myopathy (6 polymyositis/49 dermatomyositis). The median (interquartile range) duration of follow-up of patients with a negative or inconclusive FDG-PET/CT report was 14 (8-30) months. Nine patients were diagnosed with paraneoplastic myositis (16%). The tumor was located in the breast in 5 patients and in the
Discussion
In this prospective multicenter study including 55 consecutive patients with dermatomyositis/polymyositis, whole-body FDG-PET/CT scanning was comparable to conventional cancer screening for detecting occult malignant disease. The study included all patients diagnosed with dermatomyositis and polymyositis in our area over a 3-year period. The number of cases that occurred in that time is in keeping with our previously reported epidemiologic data,18 and therefore a population selection bias seems
References (24)
- et al.
Polymyositis and dermatomyositis
Lancet
(2003) - et al.
Occult malignancy in patients with suspected paraneoplastic neurologic syndromes: value of positron emission tomography in diagnosis
Mayo Clin Proc
(2008) - et al.
Incidence of malignant disease in biopsy-proven inflammatory myopathyA population-based cohort study
Ann Intern Med
(2001) - et al.
Risk of cancer in patients with dermatomyositis or polymyositisA population-based study
N Engl J Med
(1992) - et al.
Guidelines of care for dermatomyositis
J Am Acad Dermatol
(1996) - et al.
Routine vs extensive malignancy search for adult dermatomyositis and polymyositis: a study of 40 patients
Arch Dermatol
(2002) - et al.
Tumor antigen markers for the detection of solid cancers in inflammatory myopathies
Cancer Epidemiol Biomarkers Prev
(2005) Cancer and myositis: new insights into an old association
Curr Opin Rheumatol
(2006)- et al.
The role of [18F] fluoro-2-deoxyglucose-PET scanning in the diagnosis of paraneoplastic neurological disorders
Brain
(2001) - et al.
FDG-PET improves tumour detection in patients with paraneoplastic neurological syndromes
Brain
(2004)
Antibody-positive paraneoplastic neurologic syndromesValue of CT and PET for tumor diagnosis
Neurology
PET scan in clinically suspected paraneoplastic neurological syndromes: a 6-year prospective study in a regional neuroscience unit
Acta Neurol Scand
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Paraneoplastic myopathies
2024, Handbook of Clinical NeurologyDefining the clinical utility of PET or PET-CT in idiopathic inflammatory myopathies: A systematic literature review
2022, Seminars in Arthritis and RheumatismCitation Excerpt :Our review indicates that when compared to standard detection methods, PET or PET-CT performs relatively well for detecting malignancy (sensitivity 66.7–94%, specificity 80–97.8%) [12,16,23,27]. In the single prospective study, the diagnostic performance of FDG-PET-CT was equivalent to conventional malignancy screening [23]. However, PET or PET-CT is not without limitation as a single malignancy screening test: lesions that are small or have low glycolytic activity such as carcinoid tumours and low-grade lymphomas [38,39], and malignancy outside the standard field of view (e.g. melanoma in the distal extremities) may be missed [18].
Cancer and myositis: Who, when, and how to screen
2022, Best Practice and Research: Clinical RheumatologyIs it really myositis? Mimics and pitfalls
2022, Best Practice and Research: Clinical RheumatologyIt's Not All in Your Head: Thoracic Manifestations of Neurologic Diseases and Disorders
2022, Academic Radiology
Funding: This study was funded in part by a grant (FIS/2008 PI 08-0450) from the Spanish Ministry of Health and Consumer Affairs.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.
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Drs Albert Selva-O'Callaghan and Josep Ma Grau contributed equally to this work.