Paraneoplastic syndromes (PNSs) are pathologic conditions produced by neoplasms not attributable to tumor invasion or metastasis. The clinical manifestations of PNSs can precede the diagnosis; these symptoms may serve as early indicators of underlying malignancy. Standard imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), have limited sensitivity in detecting small or early-stage PNS-associated tumors. FDG PET/CT identifies hypermetabolic lesions suggestive of malignancy and, therefore, facilitates early diagnosis, refined treatment planning, and potentially prolonged patient survival. This review evaluates the diagnostic accuracy, clinical utility, and emerging role of FDG PET/CT in detecting occult malignancies. Syndrome-targeted applications discussed include limbic encephalitis, cerebellar degeneration, Lambert-Eaton myasthenic syndrome, Cushing’s syndrome, hypercalcemia of malignancy, dermatomyositis, and tumor-induced osteomalacia. In addition, the limitations of FDG PET/CT, including false-positive or false-negative findings, are reviewed, while newer PET tracers, like68Ga-DOTATATE, are also highlighted. Ultimately, FDG PET/CT has transformed clinical decision-making, enabling more timely interventions and improved patient management in the context of PNSs. Future directions in imaging, including PET/MRI and ongoing refinements in tracer design, promise to further enhance diagnostic precision, and therapeutic outcomes are also discussed.
副肿瘤综合征（PNSs）是由肿瘤引起的病理状态，而非肿瘤直接侵犯或转移所致。其临床表现可先于肿瘤诊断出现，这些症状可能成为潜在恶性肿瘤的早期预警信号。传统影像学检查方法，如计算机断层扫描（CT）和磁共振成像（MRI），在检测与副肿瘤综合征相关的小型或早期肿瘤方面敏感性有限。FDG PET/CT能够识别提示恶性肿瘤的高代谢病灶，从而有助于早期诊断、优化治疗方案，并可能延长患者生存期。本综述评估了FDG PET/CT在检测隐匿性恶性肿瘤中的诊断准确性、临床应用价值及其新兴作用。讨论的综合征导向应用包括边缘性脑炎、小脑变性、兰伯特-伊顿肌无力综合征、库欣综合征、恶性肿瘤相关高钙血症、皮肌炎及肿瘤性骨软化症。此外，本文还探讨了FDG PET/CT的局限性，包括假阳性或假阴性结果，同时强调了新型PET示踪剂（如68Ga-DOTATATE）的应用前景。最终，FDG PET/CT已改变临床决策模式，在副肿瘤综合征背景下实现了更及时的干预和改善的患者管理。文中亦探讨了影像学的未来发展方向，包括PET/MRI技术及示踪剂设计的持续优化，这些进展有望进一步提升诊断精度和治疗效果。
肿瘤(癌症)患者之家