Characterizing POEMS Syndrome with 18F-FDG PET/CT

• Published in: The Journal of nuclear medicine (1978) Vol. 56; no. 9; pp. 1334 - 1337
• Main Authors: Pan, Qingqing, Li, Jian, Li, Fang, Zhou, Daobin, Zhu, Zhaohui
• Format: Journal Article
• Language: English
• Published: United States 01.09.2015
• Subjects: Diagnosis, Differential; Female; Fluorodeoxyglucose F18; Humans; Male; Middle Aged; Multimodal Imaging - methods; POEMS Syndrome - diagnosis; Positron-Emission Tomography - methods; Radiopharmaceuticals; Tomography, X-Ray Computed - methods; Whole Body Imaging - methods; FDG; PET; POEMS syndrome
• ISSN: 1535-5667
• DOI: 10.2967/jnumed.115.160507

POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein elevation, and skin changes) syndrome is a rare paraneoplastic syndrome caused by an underlying plasma cell disorder. The patients usually present with multisystemic involvement. Thus, we performed a study to investigate the role of (18)F-FDG PET/CT in characterizing POEMS syndrome. Ninety-one untreated patients with proven or suspected POEMS syndrome were recruited to undergo (18)F-FDG PET/CT. Features of bone lesions, lymphadenopathy, hepatomegaly or splenomegaly, bone marrow, and serous cavity effusion were examined, and 15 patients were followed up with PET/CT scans 3 mo after therapy. Of the 90 patients diagnosed with POEMS syndrome, there were 140 (18)F-FDG-avid bone lesions. These lesions were frequently found in the pelvis, and most showed mixed characteristics. Four patients showed enlarged and (18)F-FDG-avid lymph nodes. Sixty-five patients had hepatomegaly or splenomegaly. Some of them had hypermetabolic spleen and bone marrow. Forty-six patients had serous cavity effusion. Five male patients had gynecomastia. Three months after therapy, (18)F-FDG-avid bone lesions showed decreased metabolism. (18)F-FDG PET/CT is a useful tool for the evaluation of patients with suspected POEMS syndrome. (18)F-FDG PET/CT may contribute to the diagnosis, evaluation, and follow-up of patients with POEMS syndrome by providing systematic findings of bone lesions, lymphadenopathy, liver or spleen involvement, serous cavity effusion, and the metabolic status of the lesions.