038 Investigatory imaging in autoimmune-paraneoplastic encephalitis. Issue 6 (27th May 2022) - Seddigh, Arshia
Abstract : Introduction: About 60% of patients with Autoimmune-Paraneoplastic Encephalitis (AIE-PNE) develop a clinical syndrome before malignancy is diagnosed. Tumour screening, early recognition and prompt treatment is likely to improve outcomes. Imaging guidelines for the management of these patients have not yet been defined. This study aimed to characterise the current use of imaging in the monitoring and management of people with AIE-PNE. Methods: We enrolled 23 patients with a diagnosis of suspected or confirmed AES-PNE (Dalmau, 2016). MRI head, whole body CT and PET scans patterns were analysed. Results: Patients had a diagnosis of suspected or confirmed AIE-PNE. A third had MRI abnormalities at presentation. 81% underwent a body CT at presentation with 20% having abnormalities. 66% had PET scans at presentation with 22% showing an abnormality. Most prevalent antibodies were NMDA (35%), LGI1 (17%) and GABA-B (9%). 14% had lung malignancy. Conclusion: Body CT was the commonest imaging investigation performed at presentation and only a little over half had further investigations if initial CT was negative. No patient that responded to initial treatment had further investigations to look for an underlying malignancy. There is an urgent need for follow up studies that will inform future imaging criteria for AIE-PNE. arshia: seddigh@nhs.net|ABN Bursary 44