Characterizing POEMS Syndrome with 18F-FDG PET/CT

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M protein elevation, and skin changes) is a rare paraneoplastic syndrome associated with plasma cell disorders.
• Patients often present with widespread multisystemic involvement, complicating diagnosis and management.

Purpose of the Study:

• To investigate the utility of 18F-FDG PET/CT in characterizing POEMS syndrome.
• To evaluate the diagnostic and follow-up capabilities of 18F-FDG PET/CT in patients with POEMS syndrome.

Main Methods:

• Ninety-one untreated patients with suspected or confirmed POEMS syndrome underwent 18F-FDG PET/CT.
• Evaluated features included bone lesions, lymphadenopathy, hepatomegaly/splenomegaly, bone marrow, and serous cavity effusion.
• Fifteen patients were followed up with PET/CT scans post-therapy.

Main Results:

• 140 18F-FDG-avid bone lesions were identified in 90 diagnosed patients, predominantly in the pelvis.
• Enlarged, hypermetabolic lymph nodes, hepatomegaly/splenomegaly, and serous cavity effusion were observed in subsets of patients.
• Post-therapy scans showed decreased metabolism in previously identified bone lesions.

Conclusions:

• 18F-FDG PET/CT is a useful tool for evaluating patients with suspected POEMS syndrome.
• This imaging modality aids in the diagnosis, staging, and follow-up of POEMS syndrome by systematically assessing bone lesions, lymphadenopathy, organ involvement, and effusion.
• 18F-FDG PET/CT provides insights into the metabolic status of lesions, facilitating treatment monitoring.