CME 10 Session – EANM’13

PET/CT in Cancers of Unknown Origin or Paraneoplastic Syndromes

Educational objectives:

Interactive presentation of real cases of patients, to illustrate the impact of PET/CT:
  1. In case of metastatic cervical lymph node with no primary cancer detected on physical examination and anatomical imaging
  2. In case of other revealing non-endocrine metastases in the whole body (lymph node, liver, lung, bone, cerebral…)
  3. Is there an added value of PET/CT when the primary tumour cannot be clearly delineated?
  4. In case of metastases of an unknown neuroendocrine tumour (CUPNET), how to choose the optimal PET tracer?
  5. Specific aspects of exploration of CUPNETs, interaction with biology
  6. What is the best trade-off between a sensitive and a specific reading in this setting?
  7. In case paraneoplastic syndrome with neurologic symptoms, are the clinical data effective to indicate PET/CT? Interaction with biology
  8. Experience available in case of non-neurologic paraneoplastic syndrome 
The audience will be equipped with voting systems. The aims are:
  1. To favour a better prescription of PET/CT among the diagnostic tools in those settings. The performance of PET/CT depends on the localisation and the histologic type of the revealing metastasis
  2. To discuss the specific aspect of PET/CT tracer choice and image acquisition in cancer of unknown origin
  3. To improve interpretation of PET/CT imaging by the attendees (avoiding pitfalls)
  4. To document the impact on patient management of a skilled interpretation of PET/CT integrating the imaging patterns, the biological results and the clinical context
The presentations will cover the current and potential role of nuclear medicine in case of cancer of unknown origin or paraneoplastic syndrome. With the help of newer histologic and biologic technologies, the indications and the imaging protocol of PET/CT may be optimised. With a great number of small anatomical structures and the presence of physiologic lymphoid tissue, head and neck which are the most frequent location of revealing lymph node metastases request the most skilled FDG PET/CT interpretation. The session will also address the particularities and main results of the PET detection of the primary lesion in neuroendocrine metastasis of an unknown origin, and in which paraneoplastic syndromes PET/CT is the most effective. Voting systems will allow the attendees to express their opinions and to evaluate their experience and skills in this field.

Key Words:
Interactive Session, Cancer of Unknown Origin, Paraneoplastic Syndrome, PET/CT, FDG, FDOPA, Somatostatin Analogues for PET

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