Conventional Cancer Screening versus PET/CT in Dermatomyositis/Polymyositis

• Published in: The American journal of medicine Vol. 123; no. 6; pp. 558 - 562
• Main Authors: Selva-O'Callaghan, Albert, MD, PhD, Grau, Josep M., MD, PhD, Gámez-Cenzano, Cristina, MD, PhD, Vidaller-Palacín, Antonio, MD, PhD, Martínez-Gómez, Xavier, MD, Trallero-Araguás, Ernesto, MD, Andía-Navarro, Eduard, MD, Vilardell-Tarrés, Miquel, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2010; Elsevier; Elsevier Sequoia S.A
• Subjects: Aged; Biological and medical sciences; Cancer; Dermatomyositis; Dermatomyositis - complications; Dermatomyositis - diagnosis; Dermatomyositis - epidemiology; Diagnosis; Diagnosis, Differential; Education; Female; Follow-Up Studies; General aspects; Humans; Imaging; Incidence; Inflammatory diseases; Internal Medicine; Male; Mammography; Mass Screening - methods; Medical diagnosis; Medical sciences; Medical screening; Middle Aged; Paraneoplastic; Paraneoplastic Syndromes - complications; Paraneoplastic Syndromes - diagnosis; Paraneoplastic Syndromes - epidemiology; Patients; Polymyositis; Polymyositis - complications; Polymyositis - diagnosis; Polymyositis - epidemiology; Positron emission tomography/computed tomography; Positron-Emission Tomography; Predictive Value of Tests; Prevention and actions; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Screening; Spain - epidemiology; Teaching; Tomography; Tomography, X-Ray Computed; Spain; Screening; Paraneoplastic; Polymyositis; Dermatomyositis; Positron emission tomography/computed tomography; Cancer; Radionuclide study; Immunopathology; Connective tissue disease; Skin disease; Radiodiagnosis; Autoimmune disease; Malignant tumor; Medical screening; Medicine; Striated muscle disease; Systemic disease; Medical imagery; Computerized axial tomography; Positron emission tomography; Comparative study
• ISSN: 0002-9343; 0924-2244; 1555-7162
• DOI: 10.1016/j.amjmed.2009.11.012

Abstract Objective To determine the value of whole-body [18 F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for diagnosing occult malignant disease in patients with myositis compared with broad conventional cancer screening. Methods We prospectively studied 55 consecutive patients with a recent diagnosis of myositis in 3 teaching hospitals over a 3-year period by whole-body FDG-PET/CT and compared the results with those of conventional cancer screening, which included thoracoabdominal CT, mammography, gynecologic examination, ultrasonography, and tumor marker analysis. Comparisons were made using predictive values and their 95% confidence intervals. Results A total of 9 of 55 patients were diagnosed with paraneoplastic myositis. FDG uptake was positive in 7 patients (1 false-positive), negative in 44 patients (3 false-negative), and inconclusive in 4 patients. Positive and negative predictive values of FDG-PET/CT for the diagnosis of cancer were 85.7% and 93.8%, respectively. Conventional screening was cancer-positive in 9 patients (2 false-positive) and negative in the remaining 46 patients (2 false-negative). Positive and negative predictive values were 77.8% and 95.7%, respectively. The overall predictive value of broad conventional screening was the same as that of FDG-PET/CT (92.7 vs 92.7). Conclusion The performance of FDG-PET/CT, a single imaging study, for diagnosing occult malignant disease in patients with myositis was comparable to that of broad conventional screening, which includes multiple tests.